Mothers' Depression, Anxiety, and Mental Representations After Preterm Birth: A Study During the Infant's Hospitalization in a Neonatal Intensive Care Unit

Abstract

Aim: This paper aimed to explore psychological functioning and mental representations in mothers of preterm infants during the child's hospitalization in a Neonatal intensive care unit (NICU).Methods: A sample including 62 mothers of premature infants (gestational age < 37 weeks) was recruited in a NICU. According to the gestational age at the time of delivery, we considered two groups: Group A included mothers whose children were born before 32 weeks of pregnancy; Group B included mothers whose children were born at or after 32 weeks of pregnancy.Within one week of childbirth, mothers were administered two self-report questionnaires: the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). When their infants' medical conditions became stable, the Clinical Interview for Parents of High-Risk Infants (CLIP) was administered to mothers.Results: The results showed high levels of depression and anxiety in both groups of mothers, with higher state anxiety scores in Group A than Group B. Besides, a series of hierarchical regression analyses were conducted with STAI, EPDS, and gestational age as predictors on the CLIP scores. Results indicated that EPDS scores predicted CLIP scores on parental self-image, support system, and readiness for discharge (p < 0.001); moreover, the interaction among depression, anxiety, and gestational age predicted the CLIP dimension of feeling of mutual recognition (p < 0.005).Conclusions: These findings suggested that a premature birth and the child's hospitalization might exert a negative effect on the mothers' emotional state, their perception of parental self-image and, consequently, the early bond with the child—independent from the infants' gestational age at the time of the preterm delivery. The data underlined the importance of involving NICU nurses and clinicians in order to optimize the care for mothers immediately after the preterm birth and during the infant's hospitalization, taking into account psychological needs of mothers of both very preterm and moderately preterm infants.

Postpartum Depression and Anxiety among Lebanese women: correlates and scales validation

“…An unwanted pregnancy may signi cantly change life, be a stressful experience with different impacts on quality of life and may trigger certain psychological problems as anxiety 51 . In our study, the delivery of premature baby is associated with PPA which concluded the same in other studies 52,53 . The underlying reasons for this relation can be depicted by the isolation that the parents are exposed to after the delivery of premature babies that mandate hospitalization due to the di culty in discharging premature infants without being admitted to neonatal intensive care units.…”

Matched cohort study of healthcare resource utilization and costs in young children of mothers with postpartum depression in the United States

“…The mean total healthcare costs were lower in both the matched infants of mothers with PPD and infants of mothers without PPD cohorts after excluding preterm deliveries. Infants of mothers with PPD had higher total healthcare costs than those without PPD, but the difference was no longer significant after excluding preterm deliveries ($18,103 vs. $16,327, p ¼ .077), suggesting preterm birth is a driver of allcause healthcare costs and supporting the previously identified relationship between preterm delivery and risk of PPD [42][43][44] . It is also possible that comorbid conditions in the preterm infant leading to increased HRU and costs could be a contributing factor to the mother's depressive symptoms, instead of the mother's mental health contributing to the infant's health.…”

Estresse materno pós-alta do recém-nascido prematuro

“…The Parent Domain may indicate sources of stress / dysfunction of the parent and child system, whose parents should be referred for evaluation and professional follow-up if levels above the 90th percentile are detected. 9 Data was analyzed according to the guidelines of the Parental Stress Index scale, with Likert-type responses and a range from one to five, corresponding to: totally agree (5); I agree (4); not sure (3); strongly disagree (2) and strongly disagree (1). The result is obtained, firstly, in absolute number or gross score, being transformed into percentile by means of the normative sample table, in which stress scores are classified as: normal stress when the percentiles are between 16 and 84; high stress to the 85th and 89th percentiles and a score equal to or above the 90th percentile, which represents a clinically significant stress level.…”

“…In addition, parents need to suddenly adapt to the condition of parents of a premature newborn, and this new condition puts them in an immediate experience of suffering, helplessness, sadness, loneliness, pain, and unpredictability of the clinical situation of the newborn child. 1 The hospitalization of premature newborns, due to their vulnerability, promotes the separation of parents and children, interfering in the formation of attachment and causing emotional distancing between the parties. [2][3] It can be shown the adaptation and reactions of mothers and fathers regarding the hospitalization of premature infants in the Neonatal Intensive Care Unit (NICU), since, since the hospitalization, different feelings related to prematurity, financial and social issues emerge among others by mothers and fathers.…”