Perinatal predictors of parenting stress trajectories during the first 3 years of parenthood: A Maternal and Child Health Handbook cohort study

BACKGROUND: Evidence of how parenting stress evolves during early childhood is limited. We aimed to identify parenting stress trajectories involving children aged 1 month to 3 years, and to determine their perinatal predictors. METHODS: Data were obtained from 3133 mothers in the Tokyo Teen Cohort (TTC), a population-based cohort of children born between 2002 and 2004. Parenting stress was self-recorded in the Maternal and Child Health Handbook (MCHH) at eight time points between 1 and 36 months postpartum. Latent class growth analysis identified trajectories; multivariate multinomial logistic regression analyzed baseline predictors from the MCHH or the TTC first wave. RESULTS: Five distinct trajectories were identified: consistently low (n = 1,691, 54.0%), consistently high (n = 158, 5.0%), consistently moderately high (n = 719, 22.9%), high-decreasing (n = 299, 9.5%), and low-increasing (n = 266, 8.5%). Compared with the consistently low group, primiparity predicted all trajectories with initially high stress: consistently high (adjusted odds ratio [aOR] 1.64, 95% confidence interval [CI] 1.13-2.37), consistently moderately high (aOR 1.92, 95% CI 1.57-2.35), and high-decreasing (aOR 1.87, 95% CI 1.38-2.54). Preterm birth also predicted the consistently high trajectory (aOR 2.38, 95% CI 1.31-4.32). Maternal alcohol consumption during pregnancy (aOR 1.33, 95% CI 1.06-1.67) and male sex (aOR 0.80, 95% CI 0.66-0.97) predicted the consistently moderately high trajectory. High maternal education (aOR 1.58, 95% CI 0.99-2.52) tended to predict the low-increasing trajectory. Maternal age, chronic health conditions, smoking during pregnancy, single-parent household, and history of infertility treatment were not significant predictors. CONCLUSION: Parenting stress follows heterogenous trajectories, necessitating repeated assessments during the first 3 years. Integrating systematic, self-recorded screenings into routine check-ups could facilitate the timely identification of evolving stress patterns. Recognizing early predictors, including primiparity and preterm birth, can further assist in identifying mothers warranting closer longitudinal monitoring.