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Maternal and Child Health Journal

, Volume 10, Issue 6, pp 473–479 | Cite as

Delivering A Very Low Birth Weight Infant and The Subsequent Risk of Divorce or Separation

  • Shailender SwaminathanEmail author
  • Greg R. Alexander
  • Sheree Boulet
Original Paper

Abstract

Background: The simultaneous rise over the last two decades in the U.S. in the proportion of VLBW (<1500 grams) deliveries and the improvement in their chance of survival has increased the number of families caring for VLBW infants and children. The families of VLBW infants with adverse outcomes can face psychological and monetary stresses, which in turn may influence marital instability and increase the risk of divorce or separation. The purpose of this paper is to identify the relationship of having a VLBW birth with the probability of divorce or separation in the first two years following delivery.

Methods: We use data from the 1988 National Maternal and Infant Health Survey (NMIHS). This national stratified, systematic “follow-back” survey augments information from birth records in 1988 by obtaining information on social, demographic, and economic variables from women that delivered a baby in 1988. We estimate a proportional discrete time hazard model of transitions to divorce/separation.

Results: Parents of a VLBW infant have 2-fold higher odds of divorce/separation compared with parents of a child with a birth weight greater than 1500 grams. Two years after delivery of a non-VLBW baby 95 percent of the marriages remain stable, while about 90 percent of the marriages remain stable following the birth of a VLBW baby. If the pregnancy was not desired, then only 85 percent of the marriages remain stable 2 years following the delivery of a VLBW infant.

Conclusions: There is an evident need to counsel and support families with VLBW infants on mechanisms to cope with the initial stressors that can be anticipated to arise.

Keywords

Very low birth weight Marital status Divorce Family disintegration Race Multiple birth Pregnancy wantedness Total words 

Notes

Acknowledgement

This work was supported in part by DHHS, HRSA, MCHB grant 5T76MC00008.

References

  1. 1.
    Arias E, MacDorman MF, Strobino DM, Guyer B. Annual summary of vital statistics – 2002. Pediatr 2003;112:1215–30.CrossRefGoogle Scholar
  2. 2.
    Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: Final Data for 2002. Natl Vital Stat Rep 2003;52:1–116.PubMedGoogle Scholar
  3. 3.
    MacDorman MF, Martin JA, Matthews TJ, Hoyert DL, Ventura SJ. Explaining the 2001–2002 infant mortality increase: data from the linked birth/infant death data set. Natl Vital Stat Rep 2005;53:1–24.PubMedGoogle Scholar
  4. 4.
    McCormick MC. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med 1985;312:82–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Allen MC. Limits of viability in the newborn. In: Burg FD, Ingelfinger JR, Wald ER, Polin RA (eds.). Current Pediatric Therapy. Philadelphia, PA: WB Sauders Co.; 1999:368–71.Google Scholar
  6. 6.
    Allen MC, Donohue PK, Dusman AE. The limit of viability – neonatal outcome of infant born at 22 to 25 weeks’ gestation. N Engl J Med 1993;329:1597–1601.CrossRefPubMedGoogle Scholar
  7. 7.
    McCormick MC, Brooks-Gunn J, Workman-Daniels K, Turner J, and Peckham GJ. The health and developmental status of very low birth weight children at school age. JAMA 1992;267:2204–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Seidman DS, Laor A, Gale R, Stevenson DK, et al. Birth weight and intellectual performance in late adolescence. Obstet Gynecol 1992;79:543–6.PubMedGoogle Scholar
  9. 9.
    LaPine TR, Jackson JC, Bennett FC. Outcome of infants weighing less than 800 grams at birth: 15 years experience. Pediatr 1995;96:479–83.Google Scholar
  10. 10.
    Lorenz JM, Wooliever DE, Jetton JP, Paneth N. A quantitative review of mortality and development disability in extremely premature newborns. Arch Pediatr Adolesc Med 1998;152:425–35.PubMedGoogle Scholar
  11. 11.
    Vohr BR, Wright LL, Dusick AM, et al. Neurological and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research network, 1993–1994. Pediatr 2000;105:1216–26.CrossRefGoogle Scholar
  12. 12.
    Hack M, Klein NK, Taylor G. Long-term developmental outcomes of low birth weight infants. Future Child 1995;5:176–96.CrossRefPubMedGoogle Scholar
  13. 13.
    Darling RB. The Economic and Psychosocial Consequences of Disability: Family-Society Relationships. Marriage Fam Rev 1987;11:45–61.Google Scholar
  14. 14.
    Yura MT. Family Subsystem Functions and Disabled Children: Some Conceptual Issues. Marriage Fam Rev 1987;11:135–51.Google Scholar
  15. 15.
    Lee SK, Penner PL, Cox MC. Comparison of the attitudes of health care professionals and parents toward active treatment of very low birth weight infants. Pediatr 1991;88:110–4.Google Scholar
  16. 16.
    Singer LT, Salvator MS, Guo S, Collin M, Lilien L, Baley J. Maternal psychological distress and parenting stress after the birth of a very low birth weight infant. JAMA 1999;281:799–805.CrossRefPubMedGoogle Scholar
  17. 17.
    Becker GS, Landes EM, Michael RT. An economic analysis of marital instability. J Political Economy 1977;85:1141–88.CrossRefGoogle Scholar
  18. 18.
    Powers ET. New estimates of the impact of child disability on maternal employment. AEA Pap Proc 2001;91:135–39.Google Scholar
  19. 19.
    Rankin RP, Maneker JS. The duration of marriage in a divorcing population: the impact of children. J Marriage Fam 1985;47:43–52.CrossRefGoogle Scholar
  20. 20.
    Sabbeth BF, Leventhal JM. Marital adjustment to chronic childhood illness: a critique of the literature. Pediatr 1984;73:762–8.Google Scholar
  21. 21.
    Lansky SB, Cairns NU, Hassanein R, Wehr J, Lowman JT. Childhood cancer: parental discord and divorce. Pediatr 1978;62:184–88.Google Scholar
  22. 22.
    Joesch JM, Smith KR. Children’s health and their mother’s risk of divorce or separation. Soc Biol 1997;44:159–69.PubMedGoogle Scholar
  23. 23.
    Taanila A, Kokkonen J, Javelin MR. The long-term effects of children’s early onset disability on marital relationships. Dev Med Child Neurol 1996; 38:567–677.PubMedCrossRefGoogle Scholar
  24. 24.
    Corman H, Kaestner R. The effects of child health on marital status and family structure. Demography 1992;29:389–408.PubMedGoogle Scholar
  25. 25.
    Mauldon J. Children’s risk of experiencing divorce and remarriage: do disabled children destabilize marriages? Popul Stud 1992;46:349–62.CrossRefGoogle Scholar
  26. 26.
    Reichman NE, Corman H, Noonan K. Effects of child health on parents’ relationship status. Demography 2004;41:569–84.CrossRefPubMedGoogle Scholar
  27. 27.
    Saigal S, Burrows E, Stoskopf BL, Rosenbaum PL, Streiner D. Impact of Extreme Prematurity on Families of Adolescent Children. J Pediatr, 137(5):701–6.Google Scholar
  28. 28.
    National Maternal and Infant Health Survey, U.S. Department of Health and Human Services, National Center for Health Statistics, Inter-University Consortium for Political and Social Research 9730.Google Scholar
  29. 29.
    Sanderson M, Placek PJ, Keppel KG. The 1988 National Maternal and Infant Health Survey: design, content, and data availability. Birth 1991;18(1):26–32.PubMedGoogle Scholar
  30. 30.
    STATA Statistical Software [computer program]. Release 8.0. College Station, Tex: Stata Corp; 2004.Google Scholar
  31. 31.
    Singer JD, Willet JB. Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence. Oxford University Press, 2003. New York. Chapters 11 &12.Google Scholar
  32. 32.
    Efron B. Logistic Regression, Survival Analysis, and the Kaplan-Meier Curve. J Am Stat Assoc 1988;83:414–25.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Shailender Swaminathan
    • 1
    Email author
  • Greg R. Alexander
    • 2
  • Sheree Boulet
    • 1
  1. 1.Department of Maternal and Child Health, School of Public HealthUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of Pediatrics, College of MedicineUniversity of South FloridaTampaUSA

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