Influence of older primiparity on childbirth, parenting stress, and mother-child interaction.

AIM: Delivery at 35 years and above has increased in Japan. While there is much research concerning obstetrical risk and delivery at advanced age, little research addresses child-rearing after birth. This study seeks to identify how older primiparas' characteristics of child-rearing, parenting stress, and mother-child interaction differ from those of younger mothers. METHODS: Participants were primipara women aged 35 years and above and primiparas aged 20-29 years; all delivered in the hospital. Questionnaires were distributed during hospitalization after birth and during home visits at 3 months, 1 year, and 2 years post-partum. Mother-child interactions during home visits were assessed using the Nursing Child Assessment Teaching Scale (NCATS). RESULTS: The older group included 13 primiparas, and the control group included seven primiparas at the study's end. Some older primiparas used fertility treatment and cesarean section, but primiparas in their 20s used neither. There were no significant differences in terms of depression, psychological health, size of networks, and number of daytime or night-time feedings. Statistically significant differences were as follows. Older primiparas experienced more social isolation and overall stress, and their children exhibited greater hypersensitivity/lack of adaptability at 3 months. Older mothers were more likely to report little effort by their children to please them at 1 and 2 years after birth. Under observation, older primiparas received higher NCATS caregiver scores, but children of primiparas in their 20s received higher child scores. CONCLUSION: Mothers and child-care specialists should recognize that older primiparas interact more favorably with their children, but have more parenting stress.

Preliminary early intervention study using Nursing Child Assessment Teaching Scale in Japan.

BACKGROUND: Mother-infant interactions have been acknowledged as one of the most important elements in measuring outcomes of parent support and infant mental health interventions. The present study was conducted to measure early intervention outcomes using the Nursing Child Assessment Teaching Scale (NCATS), and to identify factors that affected Japanese mother-infant interactions. METHODS: Healthy Japanese mother-infant dyads who had lower scores on the NCATS, indicating potential problems, were assigned to an intervention group, and compared with a control group who had higher scores on NCATS. Health-care professionals visited the intervention group dyads in their homes, and gave them positive feedback on their interactions, consultations on parenting, and health advice. The control group dyads had home visitation once every 6 months for assessment only. RESULTS: The home visitations started at 3 months of age and continued until 18 months. NCATS scores in both groups were significantly different at baseline but differences faded by the end, which suggests that the intervention promoted improved interactions in the intervention group. Two of five factors were identified as influencing mother-infant interactions: maternal age; and personal networks, and together they significantly explained 27-30% of NCATS variance. CONCLUSION: The results appear to support the validity of measuring Japanese mother-infant interactions with NCATS. This study is the first to measure the outcomes of early intervention on Japanese dyads' interactions using NCATS. Additional replication studies should be conducted elsewhere in Japan, and clinical practices for promoting mother-infant interactions should begin to assess their effectiveness with NCATS as an outcome measure.