Maternal post-traumatic stress and depression symptoms and outcomes after NICU discharge in a low-income sample: a cross-sectional study

Abstract

Background Having a preterm newborn and the experience of staying in the neonatal intensive care unit (NICU) has the potential to impact a mother’s mental health and overall quality of life. However, currently there are few studies that have examined the association of acute post-traumatic stress (PTS) and depression symptoms and infant and maternal outcomes in low-income populations. Design/ methods In a cross-sectional study, we examined adjusted associations between positive screens for PTS and depression using the Perinatal Post-traumatic stress Questionnaire (PPQ) and the Patient Health-Questionnaire 2 (PHQ-2) with outcomes using unconditional logistic and linear regression models. Results One hundred sixty-nine parents answered the questionnaire with 150 complete responses. The majority of our sample was Hispanic (68%), non-English speaking (67%) and reported an annual income of <$20,000 (58%). 33% of the participants had a positive PPQ screen and 34% a positive PHQ-2 screen. After adjusting for confounders, we identified that a positive PHQ-2 depression score was associated with a negative unit (95% CI) change on the infant’s Vineland Adaptive Behavior Scales, second edition of − 9.08 (− 15.6, − 2.6) (p < 0.01). There were no significant associations between maternal stress and depression scores and infant Bayley Scales of Infant Development III scores or re-hospitalizations or emergency room visits. However, positive PPQ and screening score were associated with a negative unit (95% CI) unit change on the maternal Multicultural Quality of Life Index score of − 8.1 (− 12, − 3.9)(p < 0.01) and − 7.7 (− 12, − 3) (p = 0.01) respectively. Conclusions More than one-third of the mothers in this sample screened positively for PTS and depression symptoms. Screening scores positive for stress and depression symptoms were associated with a negative change in some infant development scores and maternal quality of life scores. Thoughtful screening programs for maternal stress and depression symptoms should be instituted.

Prevalence of anxiety and post-traumatic stress (PTS) among the parents of babies admitted to neonatal units: A systematic review and meta-analysis

“…Eleven studies, published in 14 records, involved mothers and fathers; 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 one study involved fathers only [60] and the remaining 23 studies, reported in 26 records, involved mothers. 27 , 28 , 30 , 31 , 32 , 34 , 38 , 39 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 …”

“…Clinical interview was used in two studies, 46 , 54 clinical review of self-report scales was used in one study, published in three records, 38 , 39 , 62 and self-report scales were used in 32 studies, published in 36 records. 27 , 28 , 30 , 31 , 32 , 34 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 63 , 64 , 65 , 66 , 67 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 Seven different self-report scales were used, most commonly the Perinatal Post-traumatic Stress Disorder Questionnaire (PPQ). Cut-off points varied across studies, even when the same measure was used.…”

Impacts of Neonatal Hospitalization on Families during the 2019 Coronavirus Pandemic

“…Yet, our results may represent general variations in parent experiences since it is known that a NICU hospitalization is traumatic and overwhelming for families. 17,24,38,40 Healthcare providers working with families in the NICU must consider the additional challenges that the COVID-19 pandemic has brought to family life. Our findings indicate that families may be uniquely affected by the pandemic and its sequelae.…”

“…Prior to the COVID-19 pandemic, evidence showed that families are noticeably affected by their infant's health crisis and NICU hospitalization. 17,18 Parents of verypreterm infants are more likely to report higher rates of anxiety and depressive symptoms along with poorer family functioning both during and after NICU hospitalizations. [19][20][21] Social isolation, disruption to family routines, and unpaid time off from work were associated with negative impacts on family life.…”

Parent Mental Health and Family Coping over Two Years after the Birth of a Child with Acute Neonatal Seizures

“…The birth of a child with a medical condition that carries a risk of death, long-term health problems, or an uncertain prognosis is an extremely stressful experience for parents [ 3 ]. Parents of infants requiring neonatal intensive care unit (NICU) hospitalization are at risk for persistent anxiety, depression, post-traumatic stress and poor quality of life, which can adversely impact the long-term health and development of the child and family [ 4 , 5 ].…”