Trajectories of perinatal depressive symptoms in preterm infants’ parents: the influence of severity of prematurity and of parental role

Prematurity is widely recognized as a significant risk factor for both maternal and paternal perinatal depression (PND). Nevertheless, little is known about the PND course during the first year of preterm infant’s life in both parents. Furthermore, literature usually focuses on parents of Very Low Birth Weight-VLBW babies (birth weight <1500 grams), while less attention is paid to Extremely Low Birth Weight-ELBW infants (<1000 grams), that represents a population of great clinical relevance, given the constant increase of their survival rate, the higher risk condition for later behavioural difficulties and for maternal depression. Given these premises, the aim of the study was to explore trajectories of PND in preterm mothers and fathers, according to severity of prematurity and parental role. For the study 177 mothers and 177 fathers were recruited. According to infant birth weight, 38 parental couples were included in ELBW group, 56 couples in VLBW group and 83 in Full Term-FT group (birth weight >2500 g; gestational age >36 weeks). All parents fulfilled the Edinburgh Postnatal Depression Scale (EPDS) at 3, 9 and 12 months of infants age (corrected for preterm infants). Trajectories were tested by Growth Curve Models. Results showed that, when birth weight was included in the models, ELBW parents had higher PND levels at 3 months and a greater decrease of symptoms over time compared to VLBW and FT groups. As a function of birth weight and parental role, the higher scores at 3 months and the greater decrease over time were evident only for ELBW mothers compared to VLBW and FT mothers and fathers; no differences emerged for ELBW fathers. Findings suggest that severity of preterm birth and parental role may lead to different affective dysregulations across time, with ELBW mothers being at higher risk for PND especially in the first months after discharge. Clinical implications for intervention on parenthood in the perinatal period will be discussed.