Postpartum depression screening in the Neonatal Intensive Care Unit: program development, implementation, and lessons learned

Abstract

ObjectiveThe aims of this project were to describe the development of a postpartum depression screening program for mothers of infants in the Neonatal Intensive Care Unit and assess the implementation of the screening program.MethodsScreening began at 14 days postpartum and was implemented as part of routine medical care. A nurse coordinator facilitated communication with mothers for increasing screen completion, review of critical self-harm items, and making mental health referrals. During the 18-month study period, 385 out of 793 eligible mothers completed the screen.ResultsApproximately 36% of mothers had a positive screen that resulted in a mental health referral and an additional 30% of mothers had screening results indicating significant symptoms.ConclusionSeveral barriers were identified, leading to adjustments in the screening process, and ultimately recommendations for future screening programs and research. Development of a postpartum depression screening process in the Neonatal Intensive Care Unit involves support, training, implementation, and coordination from administrators, medical staff, new mothers, and mental health specialists. Several predictable challenges to program development require ongoing assessment and response to these challenges.RelevanceThis study highlights the expanding role of the psychologist and behavioral health providers in health care to intervene as early as possible in the life of a child and family with medical complications through multidisciplinary program development and implementation, as well as key considerations for institutions initiating such a program.

Universal Postpartum Mental Health Screening for Parents of Newborns With Prenatally Diagnosed Birth Defects

“…Rates of postpartum traumatic stress and depression risk among the SDU's patients were similar to rates found in the literature among parents with newborns admitted to the NICU (Cherry et al, 2016;Kong et al, 2013). Our findings from the 24-month project review show the importance of screening women's partners, because they showed significant clinical risks that could potentially affect the postpartum course and neonatal hospitalization.…”

Anxiety of mothers of newborns with congenital malformations in the pre- and postnatal periods

“…However, they are still underdiagnosed 9 . During the postpartum period, researchers report that 11% of mothers of healthy newborn develop symptoms of depression within 72 hours after birth 10 and that after six weeks they also presented symptoms of traumatic stress and/or anxiety 11 . In the postpartum period, there is an increased risk of suffering, especially among mothers of newborns with confirmed malformations, who will stay hospitalized after birth.…”

Parents Matter: Examination of Family Presence in the Neonatal Intensive Care Unit

“…Providing routine screening is recommended best practice and many NICUs are routinely screening family members. 43,51,52 With early identification and provision of support family members will also likely feel increasingly welcome and supported in their parenting roles in the NICU and ideally, this will translate into increased presence. Having social support staff available to meet the psychosocial needs of families is critical.…”