NICU-based Interventions To Reduce Maternal Depressive and Anxiety Symptoms: A Meta-analysis

Mendelson, Tamar; Cluxton-Keller, Fallon; Vullo, Genevieve C.; Tandon, S. Darius; Noazin, Sassan

doi:10.1542/peds.2016-1870

Cited by 93 publications

(74 citation statements)

References 34 publications

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“…No prior review has comprehensively synthesized studies of interventions to reduce distress in NICU parents at large. Previous systematic reviews selected narrow scopes that limited their applicability across varied patient populations, treatment modalities, and psychological outcomes [20][21][22][23][24]. First, few reviews examined the effect of interventions on fathers' distress symptoms, even though NICU fathers experience birth-related psychological distress [25].…”

Section: Introductionmentioning

confidence: 99%

Reducing parental trauma and stress in neonatal intensive care: systematic review and meta-analysis of hospital interventions

et al. 2019

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Objective To classify NICU interventions for parental distress and quantify their effectiveness. Study design We systematically reviewed controlled studies published before 2017 measuring NICU parental distress, defined broad intervention categories, and used random-effects meta-analysis to quantify treatment effectiveness. Results Among 1643 unique records, 58 eligible trials predominantly studied mothers of preterm infants. Interventions tested in 22 randomized trials decreased parental distress (p < 0.001) and demonstrated improvement beyond 6 months (p < 0.005). In subgroup analyses, complementary/alternative medicine and family-centered instruction interventions each decreased distress symptoms (p < 0.01), with fathers and mothers improving to similar extents. Most psychotherapy studies decreased distress individually but did not qualify for meta-analysis as a group. Conclusion NICU interventions modestly reduced parental distress. We identified family-centered instruction as a target for implementation and complementary/alternative medicine as a target for further study. Investigators must develop psychosocial interventions that serve NICU parents at large, including fathers and parents of full-term infants.

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Section: Introductionmentioning

confidence: 99%

Reducing parental trauma and stress in neonatal intensive care: systematic review and meta-analysis of hospital interventions

et al. 2019

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“…Some interventions have been developed to reduce parental depression and anxiety in the NICU, such as educational content and therapy (42). These interventions have demonstrated that it is still unclear what is the best factor.…”

Section: Parent Characteristics and Perceived Mental Distress In The mentioning

confidence: 99%

“…Separation from the infant and the interruption of the relationship between parents and newborns contribute to aggravating the already weakened family emotional state, which is commonly manifested by acute anxiety (23); Correia, Rocha & Dittz, 2019). A high stress score is also associated with a higher level of depressive symptoms (24,25).…”

Section: Introductionmentioning

confidence: 99%

Parents’ Perceived Mental Distress When Their Infant is Admitted to a Neonatal Intensive Care Unit (NICU) a Quantitative Cross-Sectional Study

Hagen¹,

Svindseth²,

Vasset³

2020

Preprint

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Background. It is normal for parents to experience a range of emotions and changes in behaviour while their newborn infant is in the NICU. The stress experienced by these parents during their infant’s hospital stay is found to affect the parent-infant relationship and their ability to bond reciprocally. Several studies have pointed out that support from family and friends can be useful for parents’ mental distress in this situation. Some differences are found between mothers’ and fathers’ experiences of the support. The aim of the current study is to examine parents’ perceived mental distress when their infant is admitted to a neonatal intensive care unit (NICU) and factors important for their support. The relationship between parents perceived mental distress and satisfaction with NICU care are spare researched. Methods. A multicentre prospective cohort study. A total of 568 parental participants from six different NICUs geographically spread throughout Norway. Hospital Anxiety and Depression Scale (HADS) and Impact of Events Scale-Revised (IES-6) were used to collect data. All the responses were rated and analysed using parametric analysis methods, descriptive statistics, logistic regression, factor analyses and linear regression analyses.Results. A total of 275 mothers reported receiving support from family and friends compared with 232 fathers. Younger parents had a higher OR of reporting anxiety compared with that of older parents. Parents with a primary or high school education level showed a higher OR of satisfaction than did parents with a college or university education level.Conclusion. There are differences in mothers’ and fathers’ responses to their experiences of various distress symptoms related to their children being in the NICU, as well as their received support from family and friends. There are also outcome differences between the age and education level of the parents and their experience of stress in the NICU. Mothers are more distressed and have more anxiety and depression than do fathers have.Trail registration: This project was first presented to the Regional Committees for Medical and Health Research Ethics which reported that the project was outside its mandate (2015/386). The project is approved from the Norwegian Data Protection Officials.

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“…The review by Mannava et al (2015) showed that attitudes and behaviors of maternal health-care providers can affect patients' well-being, satisfaction with care, and care seeking. Mendelson et al's (2017) review showed that the trauma-focused cognitive behavioral therapy (CBT) and education adapted from COPE program and problemsolving education based on CBT achieves significantly reduced maternal depressive but not anxiety symptoms.…”

Section: What Disturbs Women's Psychological Well-being and Emotionmentioning

confidence: 99%

Prenatal Mental Health: Continuous Care from Pregnancy

Yoshida

Iwayama

Jayarajah

et al. 2020

Mental Health and Illness Worldwide

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Childbirth brings biological, socioeconomical, and psychological changes to women. Health professionals need to understand fully the mother's understanding of the concept of motherhood and family. Not only psychologists and psychiatrists but also all the health staff who are working in perinatal medicine are recommended to have receptive listening skills in communication. Then it is important to receive education and training on maternal mental health to provide their service. The staff must know that most risk factors which lead women to suffer disturbances of mental health are identified during pregnancy period and that severity is different between the normal range of maternal worries and psychiatric symptoms. Prevention, care, and treatment strategy throughout this period should be well designed to be carried out in a multidisciplinary way to women at risk or in need of care. Stigma of mental illnesses is an obstacle for women who seek emotional and psychiatric support. Maternal mental care system starting from pregnancy which covers all kinds of problems is important for well-being of mothers and their families.

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NICU-based Interventions To Reduce Maternal Depressive and Anxiety Symptoms: A Meta-analysis

Abstract: Combined intervention effects significantly reduced maternal depressive but not anxiety symptoms. The evidence is strongest for the impact of cognitive behavioral therapy interventions on maternal depressive symptoms.

Cited by 93 publications

References 34 publications

Reducing parental trauma and stress in neonatal intensive care: systematic review and meta-analysis of hospital interventions

Reducing parental trauma and stress in neonatal intensive care: systematic review and meta-analysis of hospital interventions

Parents’ Perceived Mental Distress When Their Infant is Admitted to a Neonatal Intensive Care Unit (NICU) a Quantitative Cross-Sectional Study

Prenatal Mental Health: Continuous Care from Pregnancy

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