Recalled parental rearing behavior shapes mental health after preterm birth: Evidence from the Gutenberg Prematurity Study

Mareike Ernst; Alexander K Schuster; Eva Mildenberger; Daniëlle Otten; Elmar Brähler; Jonas Tesarz; Michael S Urschitz; Norbert Pfeiffer; Manfred E Beutel; Achim Fieß

doi:10.1016/j.psychres.2023.115374

Recalled parental rearing behavior shapes mental health after preterm birth: Evidence from the Gutenberg Prematurity Study

Psychiatry Res. 2023 Sep:327:115374. doi: 10.1016/j.psychres.2023.115374. Epub 2023 Jul 30.

Authors

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria. Electronic address: mareike.ernst@unimedizin-mainz.de.
² Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
³ Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
⁴ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Child and Adolescent Psychiatry-Psychotherapy, University Hospital Ulm, Ulm, Germany.
⁵ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.
⁶ Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.
⁷ Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
⁸ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.

PMID: 37574598
DOI: 10.1016/j.psychres.2023.115374

Abstract

Associations of preterm birth with later-life mental distress are well-established. A research gap concerns the role of psychosocial factors such as the family context. This study investigated associations of recalled parental rearing behavior with both preterm birth characteristics and psychological symptom burden later in life. Based on birth registry data of the Mainz University Hospital in Germany (infants born between 1969 and 2002) and using a selection algorithm, a cohort study comprising four gestational age (GA) strata was conducted (≥ 37 weeks: n = 138; 33-36 weeks: n = 132; 29-32 weeks: n = 106; ≤ 28 weeks: n = 132). Participants underwent a medical examination and completed standardized questionnaires. We investigated differences in dimensions of recalled parental rearing behavior according to GA and tested pre-/perinatal stress indicators and recalled parental rearing behavior as statistical predictors of depression and anxiety symptoms later in life. Lower GA was associated with more recalled emotional warmth and overprotection. Recalled emotional warmth was associated with fewer depression and anxiety symptoms, while recalled overprotection co-occurred with more depression symptoms. The findings indicate the relevance of parental rearing behavior for the offspring's mental health. As preterm birth implicates stress for the whole family requiring adaptive parental behavior, the latter could be an important modifiable risk factor.

Keywords: Mental health; Parental behavior; Perinatal stress; Prematurity; Recalled rearing behavior.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Female
Humans
Infant
Infant, Newborn
Mental Health*
Mental Recall
Parents / psychology
Premature Birth*