Factors associated with stress in parents of children with congenital anomalies
DOI:
https://doi.org/10.64838/jmht.2025.273259Keywords:
congenital anomalies, parents, stressAbstract
Objective: To assess the stress levels and associated factors in parents of children with congenital anomalies.
Methods: A cross-sectional survey was conducted with parents of children aged 1 month to 12 years with congenital anomalies who visited Nopparat Rajathanee Hospital between April 2023 and March 2024. Parents who were unable to read or write in Thai were excluded. Stress levels were measured using the Thai version of the Parenting Stress Index - Fourth Edition - Short Form (PSI-4-SF). Data were analyzed using descriptive statistics and odds ratios.
Results: Thirty parents were included in the study. Among them, 6.7% reported high stress levels, and 23.3% reported significant stress levels. Higher PSI-4-SF scores were more common among parents with lower education, those living without a partner, those unemployed, and those lacking support, as well as parents of older children, those diagnosed after birth, and those with longer hospital stays. However, no statistically significant risk factors were identified.
Conclusion: Parents of children with anomalies experience higher stress levels compared to parents of unaffected children. Early identification and intervention targeting modifiable factors, particularly within the first year of the child’s life, may help alleviate stress and improve outcomes for parents and families.
Downloads
References
European Registry of Congenital Anomalies and Twins. EUROCAT Description of the Congenital Anomaly Subgroups (vs.31.05.2022) [Internet]. Luxembourg: European commision; 2022 [cited 2022 Sep 1]. Available from: https://eu-rd-platform.jrc.ec.europa.eu/eurocat/data-collection/guidelines-for-data-registration_en
Golfenshtein N, Hanlon AL, Deatrick JA, Medoff-Cooper B. Parenting stress in parents of infants with congenital heart disease and parents of healthy infants: the first year of life. Compr Child Adolesc Nurs. 2017;40(4):294-314. DOI: https://doi.org/10.1080/24694193.2017.1372532
Jaschinski C, Knetsch V, Parzer P, Meyr J, Schroeder B, Fonseca E, et al. Psychosocial impact of congenital heart diseases on patients and their families: a parent's perspective. World J Pediatr Congenit Heart Surg. 2022;13(1):9-15. DOI: https://doi.org/10.1177/21501351211044127
Chinchai S, Trevittaya P, Rattakorn P, Sonsuwan N, Khwanngern K, Lekmool S. Feeding problems and treatment in cleft lip and cleft palate children. Journal of Associated Medical Sciences. 2017;50(3):533-43. (in Thai)
Al-Akour NA, Khader YS, Hamlan A. Stress among parents of infants with neural tube defect and its associated factors. Int J Nurs Pract. 2013;19(2):149-55. DOI: https://doi.org/10.1111/ijn.12049
Urichuk M, Singh C, Zrinyi A, Lum Min SA, Keijzer R. Mental health outcomes of mothers of children with congenital gastrointestinal anomalies are similar to control mothers: a longitudinal retrospective cohort study. J Pediatr Surg. 2024;59(5):918-23. DOI: https://doi.org/10.1016/j.jpedsurg.2024.01.011
Roorda D, van der Steeg AFW, van Dijk M, Derikx JPM, Gorter RR, Rotteveel J, et al. Distress and post-traumatic stress in parents of patients with congenital gastrointestinal malformations: a cross-sectional cohort study. Orphanet J Rare Dis. 2022;17(1):353. DOI: https://doi.org/10.1186/s13023-022-02502-7
Skreden M, Skari H, Malt UF, Haugen G, Pripp AH, Faugli A, et al. Long-term parental psychological distress among parents of children with a malformation—a prospective longitudinal study. Am J Med Genet A. 2010;152(9):2193-202. DOI: https://doi.org/10.1002/ajmg.a.33605
Golfenshtein N, Srulovici E, Medoff-Cooper B. Investigating parenting stress across pediatric health conditions - a systematic review. Compr Child Adolesc Nurs. 2016;39(1):41-79. DOI: https://doi.org/10.3109/01460862.2015.1078423
Lemacks J, Fowles K, Mateus A, Thomas K. Insights from parents about caring for a child with birth defects. Int J Environ Res Public Health. 2013;10(8):3465-82. DOI: https://doi.org/10.3390/ijerph10083465
Mazer P, Gischler SJ, Koot HM, Tibboel D, Van Dijk M, Duivenvoorden HJ. Impact of a child with congenital anomalies on parents (ICCAP) questionnaire; a psychometric analysis. Health Qual Life Outcomes. 2008;6:102. DOI: https://doi.org/10.1186/1477-7525-6-102
Roach MA, Orsmond GI, Barratt MS. Mothers and fathers of children with Down syndrome: parental stress and involvement in childcare. Am J Ment Retard. 1999;104(5):422-36. DOI: https://doi.org/10.1352/0895-8017(1999)104<0422:MAFOCW>2.0.CO;2
Srikosai S, Moanchai P, Kamfou C, Taweewattanaprecha S, Saipanish R. Validity and reliability of the parenting stress index of children aged 1 month to 12 years. Journal of Mental Health of Thailand. 2020;28(1):56-71. (in Thai)
Dua'a F, Kawafha MM, Abdullah KL, Shawish NS, Kamel AM, Basyouni NR. Psychological problems among parents of children with congenital anomalies. J Neonatal Nurs. 2023;29(6):846-50. DOI: https://doi.org/10.1016/j.jnn.2023.07.005
Fonseca A, Nazaré B, Canavarro MC. Parental psychological distress and quality of life after a prenatal or postnatal diagnosis of congenital anomaly: a controlled comparison study with parents of healthy infants. Disabil Health J. 2012;5(2):67-74. DOI: https://doi.org/10.1016/j.dhjo.2011.11.001
Le Gouëz M, Alvarez L, Rousseau V, Hubert P, Abadie V, Lapillonne A, et al. Posttraumatic stress reactions in parents of children esophageal atresia. PLoS One. 2016;11(3):e0150760. DOI: https://doi.org/10.1371/journal.pone.0150760
Öst E, Nisell M, Frenckner B, Mesas Burgos C, Öjmyr-Joelsson M. Parenting stress among parents of children with congenital diaphragmatic hernia. Pediatr Surg Int. 2017;33(7):761-9. DOI: https://doi.org/10.1007/s00383-017-4093-4
Peters NJ, Kaur K, Dogra S, Kaur R, Malik MA, Solanki S, et al. Factors affecting stress levels in parents of surgical neonates: A prospective observational study. J Pediatr Surg. 2022;57(12):870-5. DOI: https://doi.org/10.1016/j.jpedsurg.2022.07.013
Aite L, Trucchi A, Nahom A, Zaccara A, La Sala E, Bagolan P. Antenatal diagnosis of surgically correctable anomalies: effects of repeated consultations on parental anxiety. J Perinatol. 2003;23(8):652-4. DOI: https://doi.org/10.1038/sj.jp.7210992
Pope AW, Tillman K, Snyder HT. Parenting stress in infancy and psychosocial adjustment in toddlerhood: a longitudinal study of children with craniofacial anomalies. Cleft Palate Craniofac J. 2005;42(5):556-9. DOI: https://doi.org/10.1597/04-066r.1
Hunfeld JA, Tempels A, Passchier J, Hazebroek FW, Tibboel D. Brief report: parental burden and grief one year after the birth of a child with a congenital anomaly. J Pediatr Psychol. 1999;24(6):515-20. DOI: https://doi.org/10.1093/jpepsy/24.6.515
Calero Plaza J, Grau Sevilla MD, Martínez Rico G, Morales Murillo CP. Parenting stress and coping strategies in mothers of children receiving early intervention services. J Child Fam Stud. 2017;26(11):3192-202. DOI: https://doi.org/10.1007/s10826-017-0802-9
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Journal of Mental Health of Thailand

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
- Authorization to photocopy items for internal or personal use of specific clients, is granted. The consent does not extend to other kinds of copying, such as for general distribution, for advertising, or for resale.
- Unless otherwise states, the views and opinion expressed in Journal of Mental Health of Thailand are those of authors of the papers, and do not represent those of the editorial board or the Department of Mental Health.
