There is evidence that parenting twins adversely affects the mother’s emotional well-being, and triplet births pose even more demands. This prospective cohort study examined parenting stress and psychosocial status 1 year postpartum in 129 women having a single naturally conceived birth, 95 with a single in vitro fertilization (IVF) birth and 36 with a twin or (in 5 instances) triplet IVF birth. Participants entered the study at 18 weeks gestation and were followed up 6 weeks and 12 months after giving birth. Both the General Health Questionnaire (GHQ)-12 and Parenting Stress Index Short Form were administered. Multiple IVF births were associated with higher total parental stress scores than women with natural pregnancies and also more child difficulty and more dysfunctional parent-child interaction. Compared with singleton IVF births, women with multiple IVF births had significantly higher scores for total parenting stress, and also more child difficulty and dysfunctional interaction. The singleton natural and IVF birth groups did not differ significantly in these respects. Similar findings were obtained after excluding triplet births. Abnormal total parenting stress scores at and above the 85th percentile were found in 22% of the multiple IVF birth group, 5% of women with a singleton IVF birth, and 9% of those who conceived naturally. Mothers with multiple IVF births were less likely to be working outside the home at follow up. Only 26% of women with singleton IV births reported having felt depressed in the year after giving birth, compared with 41% of women who conceived naturally and 47% of those with multiple IVF births. There were, however, no significant differences in the frequency of medical treatment for depression or in GHQ scores. These findings confirm reports that having a singleton IVF birth is not associated with increased parenting stress. Parenting more than 1 young infant is demanding, especially for an inexperienced mother. The women studied were generally in stable long-term relationships and were able to pay for fertility treatment. The effects of multiple births are probably greater in socially and psychologically disadvantaged families.
Queens Medical Centre and the University of Nottingham, Nottingham, U.K.
Fertil Steril 2004;81:505–511