Parental Protection of Extremely Low Birth Weight Children at Age 8 Years

Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.
Journal of Developmental & Behavioral Pediatrics (Impact Factor: 2.13). 08/2007; 28(4):317-26. DOI: 10.1097/DBP.0b013e3180330915
Source: PubMed


To examine parent protection and its correlates among 8-year-old ELBW children compared with normal birth weight (NBW) controls.
The population included 217 eight-year-old ELBW children born 1992-1995 (92% of the surviving birth cohort; mean birth weight, 811 g; mean gestational age, 26.4 weeks) and 176 NBW controls. The primary outcome measure, the Parent Protection Scale (PPS), included a total score and four domains including Supervision, Separation, Dependence, and Control. Multivariate analyses were performed to examine the predictors of parental protection and overprotection.
After adjusting for socioeconomic status (SES), race, sex, and age of the child, parents of ELBW children reported significantly higher mean total Parent Protection Scale scores (31.1 vs 29.7, p = .03) than parents of NBW children and higher scores on the subscale of Parent Control (8.0 vs 7.5, p = .04). These differences were not significant when the 36 children with neurosensory impairments were excluded. Parents of ELBW children also reported higher rates of overprotection than controls (10% vs 2%, p = .001), findings that remained significant even after excluding children with neurosensory impairments (8% vs 2%, p = .011). Multivariate analyses revealed lower SES to be associated with higher total Parent Protection Scale scores in both the ELBW (p < .001) and NBW (p < .05) groups. Additional correlates included neurosensory impairment (p < .05) and functional limitations (p < .001) in the ELBW group and black race (p < .05) and maternal depression (p < .01) in the NBW group. Lower child IQ was significantly associated with higher PPS scores only in the neurosensory impaired subgroup of ELBW children.
Longer term follow-up will be necessary to examine the effects of the increased parent protection on the development of autonomy and interpersonal relationships as the children enter adolescence.

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    • "However, in a study of parents of 217 eight-year-old extremely low birth weight (ELBW), Wightman found that parents of ELBW children have higher rates of overprotection and higher scores on the control subscale than parents of normal weight children [7]. Studies indicate that the construct of the parent perception of child vulnerability is independent from that of overprotection [7]. However a mother who is overprotective may, at the same time, perceive her child to be vulnerable. "
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    • "In our recent study on parental protection of this cohort which included the neurologically abnormal subset of children, we found that child neurologic abnormality was one of the major determinants of increased parental protection (Wightman et al., 2007). Increased parental protection is also more common in low-income families and poor neighborhoods and may represent an adaptive response to dangers posed by such neighborhoods (McLoyd, 1998). "
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