***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : This study tested the efficacy of a brief intervention ( Cues program ) with mothers of very low birth weight ( VLBW < 1500 g ) infants . The primary hypothesis was that mothers in the Cues program would report lower levels of anxiety compared with mothers in the control group . Secondary hypotheses examined whether Cues mothers would report less stress , depression , and role restriction , and exhibit more sensitive interactive behavior , than control group mothers . Methods : A total of 121 mothers of VLBW infants were r and omly assigned to either the experimental ( Cues ) intervention or an attention control ( Care ) condition . The Cues program combined training to reduce anxiety and enhance sensitivity . The control group received general information about infant care . Both programs were initiated during the neonatal intensive care unit stay . Maternal anxiety , stress , depression , and demographic variables were evaluated at baseline , prior to r and omization . Postintervention outcomes were assessed during a home visit when the infant was ∼6 to 8 weeks of corrected age . Results : Although mothers in the Cues group demonstrated greater knowledge of the content of the experimental intervention than mothers in the Care group , the groups did not differ in levels of anxiety , depression , and symptoms of posttraumatic stress . They were similar in their reports of parental role restrictions and stress related to the infant 's appearance and behavior . Cues and Care group mothers were equally sensitive in interaction with their infants . Conclusion : Nonspecific attention was as effective as an early skill-based intervention in reducing maternal anxiety and enhancing sensitive behavior in mothers of VLBW infants Objective To test whether a cognitive – behaviour therapy intervention program reduces the prevalence of depression during the first postnatal year in mothers of very preterm babies BACKGROUND Postnatal and antenatal depression are a focus of considerable clinical and research attention , but little is known about the patterns of anxiety across this period . METHODS  Self-reported anxiety and depression were assessed at 18 and 32 weeks gestation and 8 weeks and 8 months postnatally in a prospect i ve longitudinal study of a community sample of women in Engl and ( n=8323 ) . RESULTS The majority of cases of postnatal depression were preceded by antenatal depression ; similarly , postnatal anxiety was preceded by antenatal anxiety . Despite the stability of anxiety and depression across this period , there was a mean decrease in both anxiety and depression . Finally , antenatal anxiety predicted postnatal depression at 8 weeks and 8 months , even after controlling for antenatal depression ( OR=3.22 , p<0.001 ) . LIMITATIONS Data were based on self-report only and there was evidence of selective attrition . CONCLUSION The findings confirm that antenatal anxiety occurs frequently , overlaps with depression and increases the likelihood of postnatal depression Prenatal psychosocial predictors of infant birth weight and length of gestation were investigated in a prospect i ve study of 120 Hispanic and 110 White pregnant women . Hypotheses specifying that personal re sources ( mastery , self-esteem , optimism )  ,  prenatal stress ( state and pregnancy anxiety ) , and sociocultural factors ( income , education , ethnicity ) would have different effects on birth outcomes were tested using structural equation modeling . Results confirmed that women with stronger re sources had higher birth weight babies ( beta = .21 ) , whereas those reporting more stress had shorter gestations ( beta = -.20 ) . Re sources were also associated with lower stress ( beta = -.67 ) , being married , being White , having higher income and education , and giving birth for the first time . There was no evidence that re sources buffered the effects of stress . The importance of personal re sources in pregnancy is highlighted along with implication s for underst and ing the etiology of adverse birth outcomes Thirty mothers of preterm infants requiring neonatal intensive care unit ( NICU ) hospitalization were assigned r and omly to one of three groups to assess differences in treatment effectiveness of facilitating parental adaptation to the NICU stresses . Groups consisted of : ( a ) a treatment group receiving videotape training in active problem-focused coping strategies ; ( b ) a treatment group receiving videotape training in emotion-focused strategies to help manage anxiety ; and ( c ) a control group receiving promotional information about the hospital and the NICU . On pretreatment measures most of the mothers exhibited little distress , a finding unlike those for the majority of NICU studies . On posttreatment follow-up both the problem-focused and emotion-focused treatment groups were significantly less anxious than the controls and lower levels of depression were observed for the emotion-focused group . Findings suggest that the coping interventions examined were cost efficient and appear promising in facilitating mothers ' coping with NICU stresses OBJECTIVE To examine how family-based interventions in the neonatal intensive care unit ( NICU ) may change  parental knowledge and behaviors and decrease stress . METHODS Eighty-four high-risk mother-infant dyads were r and omly assigned to two intervention and one control groups . Group 1 ( n = 28 ) participated in a demonstration of infant reflexes , attention , motor skills , and sleep-wake states . Group 2 ( n = 31 ) viewed educational material s. Group 3 ( n = 25 ) , controls , participated in an informal discussion . Parent-infant interactions ( Nursing Child Assessment Feeding Scale ) were videotaped . Mothers completed measures of stress ( Parenting Stress Index ) and knowledge of infant cues ( Knowledge of Preterm Infant Behavior Scale ) . RESULTS Mothers in both intervention groups evidence d greater knowledge and more contingent and sensitive interactions with their infants than did the control group . Stress also differed across groups , and all mothers reported scores above norms . CONCLUSIONS In a high-risk sample , short-term , family-based NICU interventions may enhance mothers ' knowledge , sensitivity , contingency , and stress The birth of a very small preterm infant ( ⩽ 1500 grams ) can be a traumatizing experience for many parents . A developmental risk model is presented that is the background to an early attachment-oriented preventive psychotherapeutic intervention . This comprehensive parent-centered intervention program is composed of supportive group psychotherapy , attachment-oriented focal individual psychotherapy , a home visit and video-based sensitivity training . The intervention aims at improving parental coping , the process of attachment and parent-infant interaction . In a prospect i ve longitudinal design mothers were r and omly assigned to a control ( N = 44 ) and an intervention group ( N = 43 ) after preterm delivery . Results show that the percentage of secure ( control vs. intervention group : 77.8 % vs. 59.4 % ) and insecure ( control vs. intervention group : 8.3 % vs. 31.3 % avoidant , 13.9 % vs. 9.4 % ambivalent ) attachment quality in high-risk preterm infants is comparable to results from studies with term infants . There was no significant statistical difference in terms of quality of attachment of the preterm infants between the control group and the intervention group . However , only in the control group , impaired neurological development corresponded significantly with an insecure quality of attachment , but not in the intervention group , although there were significantly more neurologically impaired infants in the intervention group . This result is discussed as an effect of the intervention program OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity BACKGROUND . Preterm birth has been associated with increased parenting stress in early infancy , and some reports have found this to be a risk factor for later behavioral problems . There are , however , few studies and conflicting results . Information about the fathers is scarce . OBJECTIVES . Our goal was to study the effects of an early-intervention program on parenting stress after a preterm birth until 1 year corrected age . METHODS . A r and omized , controlled trial was conducted including infants with a birth weight < 2000 g treated at the University Hospital of North Norway Trust , which serves the 2 northern-most counties in Norway , to examine the effects of a modified version of the Mother-Infant Transaction Program on parenting stress measured by the Parenting Stress Index . A term control group was also recruited . The Parenting Stress Index was administered to the mothers at 6 and 12 months ’ corrected age and to the fathers at 12 months ’ corrected age . The intervention consisted of 8 sessions shortly before discharge and 4 home visits by specially trained nurses focusing on the infant ’s unique characteristics , temperament , and developmental potential and the interaction between the infant and the parents . RESULTS . Seventy-one infants were included in the preterm intervention group , and 69 were included in the preterm control group . The preterm groups were well balanced . Seventy-four infants were included in the term control group . Compared with the preterm controls , both the mothers and fathers in the preterm intervention group reported significant lower scores in child domain , parent domain , and total stress on all occasions except the mother-reported child domain at 12 months . These differences were not related to birth weight or gestational age . The level of stress among the preterm intervention group was comparable to their term peers . Both parents in the intervention group reported consistently lower scores within the distractibility/hyperactivity , reinforces parents , competence , and attachment subscales compared with the preterm control group . There were no differences in mean summary stress scores between the mothers and fathers in the 2 preterm groups at 12 months , but the intraclass correlation coefficient was higher in the intervention group . CONCLUSIONS . This early-intervention program reduces parenting stress among both mothers and fathers of preterm infants to a level comparable to their term peers . We are now study ing whether this will result in long-term beneficial effects PURPOSE : To determine whether significant symptoms of acute stress disorder ( ASD ) are present in mothers of premature infants in the neonatal intensive care unit ( NICU ) . SUBJECTS : Forty mothers of premature infants born less than 33 weeks and admitted into NICU . DESIGN : Prospect i ve , cohort , within-subjects . METHODS : Mothers completed the Stanford Acute Stress Reaction Question naire , Edinburgh Postnatal Depression Scale , and the Acute Stress Disorder Interview to explore the number and severity of stress-related symptoms at 2 separate time periods , 7 to 10 days after birth , and 1 month after birth . RESULTS : Twenty-eight percent of the mothers met diagnostic criteria of ASD at 7 to 10 days after birth , and at 1 month after birth ASD symptoms persisted . The majority of the mothers described premature birth as a traumatic stressor . The most commonly met criteria were dissociation and anxiety . Significant symptoms of depression were found in 43 % of mothers and persisted 1 month after birth . Rates of depression and moderate to severe symptoms of ASD were significantly related in mothers at 1 week and at 1 month after birth . CONCLUSIONS : The premature birth experience is traumatic for mothers and may lead to various emotional responses including stress-related symptoms such as depression and /or ASD . Mothers with significant symptoms of depression and those with symptoms of stress seem to be more at risk for developing symptoms of ASD OBJECTIVE . Although low birth weight premature infants and parents are at high risk for adverse health outcomes , there is a paucity of studies that test early NICU interventions with parents to prevent the development of negative parent-infant interaction trajectories and to reduce hospital length of stay . Our objective was to evaluate the efficacy of an educational-behavioral intervention program ( ie , Creating Opportunities for Parent Empowerment ) that was design ed to enhance parent-infant interactions and parent mental health outcomes for the ultimate purpose of improving child developmental and behavior outcomes . DESIGN , SETTING , AND PARTICIPANTS . A r and omized , controlled trial was conducted with 260 families with preterm infants from 2001 to 2004 in 2 NICUs in the northeast 
    Output:
    
There is evidence that mothers of very preterm infants of low-birth-weight experience major depression for up to 12 months following PTB .
Sound interventions implemented during and following infant hospitalization and grounded in coping and self-regulation had a small to moderate effect in reducing maternal depression and anxiety and parenting stress for up to 2 months and 12 months respectively .