Quality of Life Research

, Volume 21, Issue 9, pp 1565–1576 | Cite as

Health-related quality of life of mothers of very low birth weight children at the age of five: results from the newborn lung project statewide cohort study

  • Whitney P. Witt
  • Kristin Litzelman
  • Hilary A. Spear
  • Lauren E. Wisk
  • Nataliya Levin
  • Beth M. McManus
  • Mari Palta



This study aimed to determine the health-related quality of life (HRQoL) in mothers of 5-year-old very low birth weight (VLBW) and normal birth weight (NBW) children, with a focus on the role of stress.


This cohort study is ancillary to the Newborn Lung Project. A telephone interview collected information on symptoms of stress and HRQoL from 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Staged multiple regression analyses were used to evaluate the relationship between caregiver status and maternal HRQoL and the role stress played in this relationship. Additional multiple regression analyses were also used to evaluate the correlates of poor maternal HRQoL among VLBW mothers.


Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children. Adjusted analyses showed that physical HRQoL was significantly different between these mothers (β: −1.87, P = 0.001); this relationship was attenuated by maternal stress. Among the mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were aged five. Child behavior problems at the age of two were also associated with worse subsequent maternal mental HRQoL (β: −0.18, P = 0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (β: −0.26, P = 0.02).


Caring for a VLBW child is negatively associated with the HRQoL of mothers; this relationship might be, in part, explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL.


Very low birth weight Maternal stress Maternal health-related quality of life Life course 



Health-related quality of life


Very low birth weight (<1,500 g)


Low birth weight (<2,500 g)


Normal birth weight


Newborn Lung Statewide Cohort Study


Standard deviation


Effect size


Neonatal intensive care unit



This research was supported by grants from the National Institute of Child Health and Human Development (P30HD03352, Principal Investigator Marsha Mailick Seltzer and HD049533, Principal Investigator Whitney P. Witt). Birth-related and age two data collections were supported by a grant from the National Heart Lung and Blood Institute (R01 HL38149, Principal Investigator Mari Palta). Lauren E. Wisk was supported by a grant from the Graduate School of the University of Wisconsin, Madison (Principal Investigator: Witt) and a predoctoral NRSA Training Grant (T32 HS00083; Principal Investigator: Maureen Smith). Beth M. McManus acknowledges funding from the Robert Wood Johnson Health and Society Scholars Program at University of Wisconsin-Madison (53574; Principal Investigator: John Mullahy). Thank you to all of the parents who participated in this study. Thanks also to Mona Sadek Badawi and Aggie Albanese for their overall assistance in data acquisition and management. Thank you to Kathleen Madden for her help with telephone interviews, and to Ian Bakk for his assistance with data entry. We also wish to thank the anonymous reviewers for their valuable comments and input.

Conflict of interest

None of the authors has declared a conflict of interest with this research.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Whitney P. Witt
    • 1
  • Kristin Litzelman
    • 2
  • Hilary A. Spear
    • 6
  • Lauren E. Wisk
    • 3
  • Nataliya Levin
    • 4
  • Beth M. McManus
    • 7
  • Mari Palta
    • 5
  1. 1.Department of Population Health Sciences, School of Medicine and Public HealthUniversity of Wisconsin, MadisonMadisonUSA
  2. 2.Department of Population Health Sciences, School of Medicine and Public HealthUniversity of Wisconsin, MadisonMadisonUSA
  3. 3.Department of Population Health Sciences, School of Medicine and Public HealthUniversity of Wisconsin, MadisonMadisonUSA
  4. 4.Department of Population Health Sciences, School of Medicine and Public HealthUniversity of Wisconsin, MadisonMadisonUSA
  5. 5.Department of Population Health Sciences, School of Medicine and Public HealthUniversity of Wisconsin, MadisonMadisonUSA
  6. 6.College of NursingUniversity of ColoradoDenverUSA
  7. 7.Department of Health Systems, Management and Policy and the Children’s Outcomes Research GroupUniversity of ColoradoDenverUSA

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