Scripties UMCG - Rijksuniversiteit Groningen
 
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Intensive multidisciplinary post-discharge follow-up programme for premature and dysmature infants: effect on parental psychological symptoms and quality of life

(2019) Fokkert, M. (Marlène)

Background: Parents of pre- and dysmaturely born infants report more psychological symptoms than parents of full-term infants. An intensive post-discharge follow-up programme may positively influence these symptoms.
Objective: To examine the effect of multidisciplinary post-discharge follow-up programme for pre- and dysmature infants on parental psychological symptoms.
Methods: Prospective cohort study including parents of premature (<34 weeks) and dysmature (<1500 grams) infants in the Women and Children’s Hospital; Isala Zwolle, The Netherlands. In September 2011 we introduced a multidisciplinary outpatient follow-up programme for pre- and dysmaturely born patients, involving structured support by a dedicated team of primary and secondary healthcare professionals and paramedics. Patients and their parents seen for follow-up by a paediatrician in the year before introduction of this programme (control group), were compared to patients and their parents after introduction of this programme (intervention group). At 5 moments – at admission (T0), discharge (T1) and 6 (T2), 12 (T3) and 18 (T4) months after discharge – parents were asked to complete questionnaires regarding psychological symptoms and quality of life (QoL): Brief Symptom Inventory (BSI), General Health Questionnaire (GHQ-12) and Short Form (36) Health Survey (SF-36).
Results: We included 221 infants and 353 parents: 67 controls (median gestational age 31+4 weeks (p25 29+6, p75 32+6), mean birth weight 1634 grams (SD 504)) and 154 in the intervention group (median gestational age 32+1 weeks (p25 29+5, p75 33+1), mean birth weight 1668 grams (SD 487)). At admission 16.8% (control) and 22.5% (intervention) of the parents experienced psychological symptoms according to BSI and 34.7% (control) and 41.7% (intervention) according to GHQ-12 scores. Mothers 2.18 (95% CI 1.24-3.85, p 0.006) and 2.16 (95% CI 1.36-3.43, p 0.001) times more than fathers according to BSI and GHQ scores, respectively. Low QoL (≤p16) was seen in 29.0% (control) and 32.3% (intervention). Significant reduction in parental psychological symptoms were established within the first half year. However, no differences were found between control and intervention group: neither at any of the 5 moments, nor for the difference in initial (T0 or T1) and final (T4 or T3) scores.
Conclusions: A relative small, but still considerable number of parents of pre- and dysmature infants report psychological symptoms, mothers more than fathers, during the first period after birth. These symptoms diminish within the first half year. A multidisciplinary post-discharge follow-up programme doesn’t seem to influence the course nor severity of these parental psychological symptoms.






 
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