Premature singleton versus a twin or triplet infant death: parental adjustment studied through a personal interview

Abstract

Par ental adjustment fol l ow i ng the death of a pr ematur e si ngl eton or mul ti pl e bi r th i nfant has hi ther to been studi ed by mai l ed questi onnai r es or tel ephone sur vey. I n the pr esent study, usi ng an i n-depth per sonal i nter vi ew, gr i ef r eacti ons and adjustment patter ns of ni ne families who lost a si ngl eton pr ematur e i nfant ('Si ngl e Gr oup') w er e compar ed w i th those of ni ne fami l i es w ho l ost one of a pr ematur e mul ti pl e bi r th cohor t ('M ul ti pl e Gr oup'). The i nter vi ew w as conducted 1-4 year s after the death of the i nfant and eval uated speci fi c ar eas or 'scal es' of l i fe adjustment, i ncl udi ng i ndi vi dual feel i ngs, r el ati onshi p betw een husband and w i fe, and functi oni ng at home and at w or k . Ther e w as no si gni fi cant di ffer ence betw een the pater nal and mater nal l evel of adjustment of the tw o gr oups i n any of the studi ed scal es. A posi ti ve cor r el ati on w as found betw een mater nal and pater nal gr i ef r eacti on of the same fami l y i n the scal es of i ndi vi dual feel i ngs (r = 0.65), r el ati onshi ps betw een husband and w i fe (r = 0.70), and functi oni ng at home (r = 0.57). Compar i ng the father 's scal e w i th the mother 's scal e r eveal ed a si gni fi cant di ffer ence onl y i n the ar ea of 'i ndi vi dual feel i ngs'. The gestati onal age, mater nal bondi ng dur i ng hospi tal i sati on of the i nfant and the par ental attendance at the event of death w er e si gni fi cantl y associ ated w i th the pr ocess of par ental adjustment. The r esul ts of thi s study suppor t pr evi ous r epor ts of si mi l ar par ental r eacti ons fol l ow i ng the demi se of a pr ematur e si ngl eton or mul ti pl e bi r th i nfant. Si nce soci etal envi r onment may not r ecogni se the need for consol ati on of these fami l i es, car e, compassi on, and sensi ti vi ty shoul d be encour aged i n deal i ng w i th these par ents at the ti me of thei r i nfant' death, and for a l ong ti me ther eafter.Keyw or ds: preterm death, si ngl eton, tw i n, parental adjustment I ntr oducti on Neonatal l oss i s a very traumati c event for the fami l y involved, and its psychological implications have become the subject of expandi ng research.1-14 Some evi dence has been presented i ndi cati ng that the l onger the antenatal or postnatal bondi ng peri od w i th the i nfant, the deeper and more persi stent are the gri ef reacti ons experi enced by the parents. 1,3,5,6,11,15 Father and mother apparentl y do not gri eve uni forml y. 5,6,9,12,13,[16][17][18][19][20][21][22][23][24][25][26] M ost studi es of i nfant death refer to mi xed popul ati ons: mi scarri age, still birth, neonatal death and SIDS. 3,5,12,13,[16][17][18]20,21,23,25 The grow i ng number of mul ti pl e gestati on del i veri es resul ti ng from hormonal therapy and in vitro ferti l i sati on has l ed al so to an i ncreasi ng occurrence of a neonatal mul ti pl e bi rth death i n the premature nurseri es. 6,[27][28][29][30] In these turbul ent si tuati ons, parents m...

How Couples Cope With the Death of a Twin or Higher Order Multiple

“…Among other differences, these mothers suffered significant grief for longer periods than bereaved singleton mothers (Lang & Gottlieb, 1993;Potvin et al, 1989;Zeanah et al, 1995) and expressed more anxiety and depression. Similarly, earlier studies found that mothers and fathers of multiples did not experience significantly less grief compared with parents who had experienced the death of a singleton (Netzer & Arad, 1999;Wilson et al, 1982;Wilson et al, 1985).…”

“…The authors speculated that such a delay could reduce the potential for others to recognize the need for help and assist fathers (Wilson et al, 1985). All three studies found that over time the differences between mothers and fathers became less apparent and parental grief diminished (Netzer & Arad, 1999;Wilson et al, 1982;Wilson et al, 1985). However, Wilson et al (1985) found that mothers continued to report a greater need for social support than fathers.…”

“…Conversely, when partners were controlling yet showed little care for the mothers, there was greater risk of postpartum depression (Matthey et al, 2000). Both parents would like others to initiate discussion with them about the baby (Netzer & Arad, 1999;Wilson et al, 1982). However, mothers and fathers with depressive symptoms have been found to differ in their need for social interaction and in the timing of that need (Wilson et al, 1982;Wilson et al, 1985).…”

“…Three studies have reported on how bereaved multiple birth couples cope with their loss compared with coping in couples who had lost a singleton (Netzer & Arad, 1999;Wilson et al, 1982;Wilson et. al., 1985).…”

Views of Bereaved Multiple-birth Parents on Life Support Decisions, the Dying Process, and Discussions Surrounding Death

“…[11][12][13] Previous studies of multiple-birth loss focused principally on grief. [14][15][16][17][18][19][20][21][22] The present study presents feedback from bereaved multiple-birth parents about life-support decisions and care surrounding their children's deaths.…”