Psychosocial stress factors in families with preterm infants during the Covid-19 pandemic: a cross-sectional study.

backgroundThe Covid-19 pandemic restrictions severely impacted parents' and children's mental and physical health. Families with pre-existing stress factors may have been particularly affected. Parental stress following premature birth is well acknowledged. The addition of the pandemic restrictions to stressors related to premature birth may constitute an especially high-risk factor for family stress and thereby neuropsychological development. Accessibility to special preterm follow-up care programs is important for neuropsychological development and faced additional relevance in the face of pandemic related stressors. We studied the hypothesis that families with preterm born infants were particularly adversely affected by the pandemic-related restrictions in comparison to families with term born infants. Specific stress factors were explored as well as the accessibility of support programs.

methodsIn this cross-sectional study, families were recruited in a neonatology unit with the highest level of care according to German regulations. A questionnaire on perceived pandemic stress factors including amongst others: social contacts, family support, intrafamilial conflicts, leisure activities, and family planning was completed by 101 parents of prematurely born infants while pandemic related restrictions were still in place. We distinguished preterm infants with low gestational age and birth weight from other preterm infants and term born infants. T-tests, Chi-Square tests, Kruskal-Wallis tests, and binary logistic regression analysis were applied to compare the subgroups.

resultsThe stress levels resulting from restricted social contacts, family conflicts and accessibility to family support services were significantly higher in families with term-born infants. The accessibility of targeted follow-up care programs for preterm infants was significantly lower for moderate and late preterm infants. The pandemic has had an influence on the decision of parents to have more children in both groups.

conclusionFamilies with preterm infants were less stressed by the pandemic than those with term infants. Targeted follow-up care focused on high-risk groups and left moderate and late preterm infants without medical check-ups. This reflects the general focus in society on high-risk populations during the pandemic. The pandemic had an influence on family planning in both groups.