Medical advancements of the last decades have provided miracles for many parents. Babies born at 23 to 24 weeks now have a close to 50 percent survival rate. But the greater health care needs of very premature and very low birth weight babies place additional financial, mental, and physical burdens on families.
Parents of very preterm (VP) and very low birth weight (VLBW) infants have to sort through a tangle of wires to reach their babies, who may face a host of medical complications, including poor oxygen saturation, unregulated body temperature, weight loss, and infection.
In addition to all of these immediate health concerns, parents of NICU babies face an uncertain future. You may also be overwhelmed by the challenges ahead. How will you and your family face your child's possibly profound physical and mental challenges? How will your work and relationships change as you care for your child? Will you be happy?
You should be encouraged by a study recently published in Pediatrics. The Bavarian Longitudinal Study followed very preterm infants (younger than 32 weeks), very low birth weight infants (less than 1500 grams, or about 3.3 pounds), and term infants from birth to adulthood. The study has been following children since their births in 1985 and 1986. This new paper focuses on those children as they transitioned into adulthood.
Previous studies have followed the transition to adulthood for those born VP and VLBW, looking at physical and mental challenges for both the adult children and their parents. Children born VP or VLBW have a higher rate of disability, more mental health issues, lower academic achievement, and poorer peer relationships than children born at full term. The researchers wanted to know if those same factors led to differences in parental quality of life.
Researchers measured parents' quality of life and found no major differences in quality of life between parents of children who were born very premature or with very low birth weight and parents who had full term babies.
Although children born VP or VLBW had significantly more disabilities and academic performance issues, the researchers found that these factors did not impact parental quality of life. The researchers conclude that, at least in countries with universal health care, "parents of VP and VLBW children on average show remarkable ability to cope with the challenges presented to them."
Two factors did impact parents' quality of life: their children's mental health and their children's friendships in childhood. The parents of children who reported a higher number of friendships between six and eight years of age experienced a higher quality of life as those children reached adulthood.
Although there are significant differences between the American and German health care and education systems, the findings of the Bavarian Longitudinal Study still have important consequences for American families. First, the results should be encouraging to parents currently in NICUs. Although your life may not look quite as you imagined when planning for this baby, research suggests that the medical challenges ahead won't change your future happiness.
The study also has implications for our society as a whole. If it's true that children's mental health and peer relationships in childhood have the greatest long-term impact on parents' quality of life, by attending to children's mental health and peer relationships we can improve the overall quality of life for two generations.
At the institutional level, this may mean focusing more resources on mental health and relationship building for all children, as well as developing strategies for more inclusive classrooms. At the personal level, this may mean encouraging our children to build friendships with all of their peers, even when it means more effort, flexibility, or creativity on the part of parents when scheduling play dates or parties.
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