Depression and anxiety symptoms of mothers of preterm infants are decreased at 4 months corrected age with Family Nurture Intervention in the NICU

Abstract

Preterm delivery can precipitate maternal psychological morbidities. Family Nurture Intervention (FNI) was designed to minimize these by facilitating the emotional connection between mother and infant, beginning early in the infant's neonatal intensive care unit (NICU) stay. We examined depression and anxiety symptoms of mothers of preterm infants at 4 months infant corrected age (CA). One hundred fifteen mothers who delivered between 26 and 34 weeks gestational age were randomized to receive standard care (SC) or standard care plus FNI. Mothers' self-reported depressive symptoms (Center for Epidemiologic Studies Depression Scale: CES-D) and state anxiety (Spielberger State-Trait Anxiety Inventory: STAI) symptoms were assessed at enrollment, near to term age, and 4 months (CA). At 4 months CA, mean CES-D and STAI scores were significantly lower in FNI mothers compared to SC mothers. Effectiveness of FNI can only be evaluated as an integrated intervention strategy as it was not possible to control all aspects of FNI activities. Although there was considerable loss to follow-up, analyses suggest that resulting biases could have masked rather than inflated the measured effect size for depressive symptoms. FNI may be a feasible and practicable way to diminish the impact of premature delivery on maternal depressive and anxiety symptoms.

Relationship among Depression, Anxiety and Mother-Infant Bonding in Mothers of Premature Babies

“…The findings showed that the majority of the studied sample was between the age group of (20-30) years old and that is congruent with the findings of Petit, et al, Ionio, et al, Welch, et al, and Vazquez who found that their samples were in the same age group [17,11,23,22]. Regarding the mothers' educational level, about less than half of the studied sample had secondary school education.…”

“…This result is in the same line with [17]. On the other hand, this finding is dissimilar to the findings of Ionio, et al and Welch, et al who found that the majority of their samples had more than high school education [11,23]. Education can play an important role in determining the mothers' adherence to healthy lifestyles which in return affect the progress of healthy pregnancy and can reduce the risk for having premature baby.…”

Calming Cycle Theory and the Co-Regulation of Oxytocin

“…Results of the trial showed that an average of four facilitated calming sessions per week between mother and infant significantly improved FNI maternal caregiving behaviors at 36 weeks and decreased maternal depressive and anxiety symptoms in infants assessed at 4 months of age (Welch, Halperin et al, 2016). FNI infants showed highly significant increases in EEG power and decreases in EEG coherence at term age in frontal areas associated with socio-emotional outcomes that predict improved outcomes Myers et al, 2015;Welch, Myers et al, 2014).…”

Autonomic regulation of preterm infants is enhanced by Family Nurture Intervention

“…The initial randomized clinical trial (RCT), comparing FNI with standard care (SC) demonstrated feasibility and safety of the intervention (Welch et al, ), showed that FNI mothers exhibited increased maternal sensitivity during normal caregiving activities when their infants were approximately 36 weeks postmenstrual age (PMA) (Hane et al, ), and decreased symptoms of anxiety and depression when their infants were 4 months corrected age (Welch et al, ). At ~41 weeks PMA, FNI infants had robustly increased high‐frequency electroencephalogram (EEG) power (Welch et al, ), altered EEG‐based functional connectivity (Myers et al, ), and advanced maturation (Welch et al, ).…”