Mothers' psychological distress 1 year after very preterm childbirth. Results of the EPIPAGE qualitative study.

BACKGROUND

The objectives of this study were to assess qualitatively mothers' physical and psychological health, their perception of their child's health and development, and their difficulties with childcare from 2 months post discharge to 1 year after a very preterm delivery.

METHODS

The study population included all mothers who delivered before 33 weeks of amenorrhea between November 1998 and November 1999 in a Parisian maternity unit and between February 2000 and February 2001 in a maternity unit located in Rouen (France). Twenty-one of the 38 mothers contacted agreed to participate (55%). Semi-structured interviews were conducted by a clinical psychologist at the woman's home. They were taped, fully transcribed and subjected to content analysis.

RESULTS

The main difficulties reported by mothers at 1 year were fatigue, depressive mood, anxiety and physical symptoms. Depressive mood was associated with social isolation, post-traumatic symptoms, withdrawal and feelings of guilt. Most mothers also described their child as being difficult and tiring. Mothers' reports about their own health and difficult behaviour of their child were more negative at 1 year than at 2 months post discharge.

CONCLUSIONS

The mothers' psychological distress following a very preterm birth did not improve between 2 months post discharge and 1 year after delivery. Comprehensive follow-up care programmes should take into account this consequence of a very preterm birth and provide access to adequate psychological support, care or treatment.