Impact of preterm birth on parental separation: a French population-based longitudinal study

BMJ Open. 2017 Nov 16;7(11):e017845. doi: 10.1136/bmjopen-2017-017845.

Abstract

Objective: The objective of this study was to investigate both the effects of low gestational age and infant's neurodevelopmental outcome at 2 years of age on the risk of parental separation within 7 years of giving birth.

Design: Prospective.

Setting: 24 maternity clinics in the Pays-de-la-Loire region.

Participants: This study included 5732 infants delivered at <35 weeks of gestation born between 2005 and 2013 who were enrolled in the population-based Loire Infant Follow-up Team cohort and who had a neurodevelopmental evaluation at 2 years. This neurodevelopmental evaluation was based on a physical examination, a psychomotor evaluation and a parent-completed questionnaire.

Outcome measure: Risk of parental separation (parents living together or parents living separately).

Results: Ten percent (572/5732) of the parents reported having undergone separation during the follow-up period. A mediation analysis showed that low gestational age had no direct effect on the risk of parental separation. Moreover, a non-optimal neurodevelopment at 2 years was associated with an increased risk of parental separation corresponding to a HR=1.49(1.23 to 1.80). Finally, the increased risk of parental separation was aggravated by low socioeconomic conditions.

Conclusions: The effect of low gestational age on the risk of parental separation was mediated by the infant's neurodevelopment.

Keywords: cohort; low gestational age; neurodevelopment outcome; parental separation.

MeSH terms

  • Child
  • Child Development*
  • Child, Preschool
  • Female
  • France
  • Gestational Age
  • Humans
  • Infant
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Longitudinal Studies
  • Male
  • Marital Status*
  • Marriage / psychology
  • Marriage / statistics & numerical data
  • Parents*
  • Pregnancy
  • Premature Birth / epidemiology*
  • Premature Birth / psychology
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires