(PS4-26) Preterm Parenting Stress and Parents’ Romantic Relationship Functioning: A Systematic Review

Background: Evidence indicates that having a child leads to a decrease in parents’ romantic relationship quality. Preterm children often have additional stressors (e.g., medical concerns, behavioral problems) that may further impact their parents’ parenting experience and relationship quality. Preterm birth is a growing public health concern and racial health disparity, as black infants have a 50% higher risk of prematurity. Understanding the experience of parents of preterm children may inform the development of supportive strategies for parents and their relationships, which may particularly impact Black families, who face increased risk. This review aims to summarize this research and provide recommendations for future research and clinical endeavors.

Method: We originally identified relevant articles using PubMed, PsycINFO, and Scopus and used citation chaining to identify additional articles. In total, we screened the titles and abstracts of 1831 articles and reviewed the full text of 50 articles, of which 25 were eligible for our study. We merged five articles, resulting in a final sample of 20 studies. Two researchers extracted data from our final sample, including study characteristics and key findings. Two researchers completed quality assessment using the Quality Assessment Tool for Observational Cohort and Cross-Sectional. We used a narrative synthesis strategy that incorporated the Vulnerability-Stress-Adaptation (VSA) model to summarize our findings.


Results: Study findings indicated inconsistent patterns in the associations between preterm parenting stress and romantic relationship functioning. Some articles (n = 4) suggested negative associations between parenting stress and romantic relationship functioning, while others suggested a positive (n = 1) or insignificant (n = 7) association. Two articles described the positive (e.g., bringing couples closer together) and negative (e.g., straining relationship) impacts of preterm birth on romantic relationship functioning. The VSA model does not fully encompass important aspects of parents’ experiences, such as the role of social support. Most articles were quantitative (n = 19), with only one article using a mixed methods approach. Few articles reported participants’ gender identity (n = 3) or sexuality (n = 1). Many samples reported only the mother’s characteristics (n = 9). Of the 12 studies that reported participants’ racial and ethnic identities, 10 had a majority White sample. No articles discussed the impact of parents’ identities on their parenting and relationship experiences.

Conclusions: Findings support the development and adaptation of clinical interventions to assist parents of preterm children. Generally, evidence suggests that having a preterm child may not impact parent’s relationship functioning more than having a term child, however, it is unclear whether the stress of having a preterm child may be more impactful for an individual facing minority stress (e.g., a person of color). Future research should report parents’ identities (i.e., race/ethnicity, sexuality, gender) and employ mixed method strategies to contextualize the variance in parents’ experiences.