The experiences of mothers with preterm infants within the first-year post discharge from NICU: social support, attachment and level of depressive symptoms

Abstract

Background The estimated global premature birth rate for 2014 was 10.6%, equating to an estimate of 14.84 million live premature births. The experience of premature birth does not impact solely on the infant and mother as individuals but occurs in the context of a critical point in time when they are developing a relationship with one another. The aim of this study was to investigate the relationships between social support, mother to infant attachment, and depressive symptoms of mothers with preterm infants within the first 12 months’ post discharge from the Neonatal Intensive Care Unit (NICU). Methods A correlational cross-sectional study design was used. Data were collected using a four-part online survey which included the Perinatal Social Support Questionnaire (PICSS), Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) with mothers of preterm infants (n = 140). Results The prevalence of postnatal depression was 37.9% (95% CI: 29.8 to 46.4%). In univariable analyses, history of depression (p = 0.005), aged 35–39 years (p = 0.006), no formal social support (p = 0.040), less informal social supports (p = 0.018), lower overall maternal attachment (p < 0.001) and lower overall functional social support (p < 0.001) were significantly associated with a higher level of depressive symptoms. Lower scores on two of the maternal attachment subscales (quality of attachment and absence of hostility) and all four of the functional social support subscales were significantly associated with a higher level of depressive symptoms (p < 0.001 for all). In the multivariable analysis, prior history of depression (p = 0.028), lower score of maternal attachment (p < 0.001) and lower emotional functional social support (p = 0.030) were significantly associated with a higher level of depressive symptoms. Conclusion Women who experience a premature birth, have a prior history of depression, poor infant attachment and poor emotional social support have a higher level of depressive symptoms. Results emphasise the need for professionals to encourage mobilisation of maternal formal and informal social supports. It is important to intervene early to address maternal emotional well-being and enhance the developing mother-preterm infant relationship.

RETRACTED ARTICLE: Mothers’ experiences of caring for preterm babies at home: qualitative insights from an urban setting in a middle-income country

“…These findings are consistent with other studies which found numerous negative and fewer positive maternal experiences [4,6,7,25,26]. Mothers of preterm babies are at risk of mental health challenges within the first year post-delivery [4,27]. We found that mothers were sleep-deprived, stressed, and had burnout which can further compound depressive symptoms.…”

“…Transitional care models utilized in well-resourced settings can be adapted to include community health workers [11,26]. It has been established that mothers who receive formal structured support from health professionals have a lower level of depressive symptoms and less anxiety [26,27]. The mothers in this study did not mention having received any formal support.…”

Relationship dynamics: the protective effect of relationship satisfaction and dependency on parents’ mental health after having a preterm baby

“…A synthesis of the findings from the descriptive studies reports that anxiety, helplessness and loss of control, and fear, as well as guilt and shame, depression and sadness, and a sense of failure and disappointment are the most typical feelings parents experience. Although studies indicate that extreme anxiety of parents decreases over time, parents still have worries and related anxiety when the infant is discharged home for care (Leahy-Warren et al, 2020;Treyvaud et al, 2019). Schappin et al (2013) reported that the stress levels of parents of preterm and term infants do not differ significantly.…”

Health care staff support for mothers in NICU: a focused ethnography study

“…Supporting the parents results in decreasing their anxiety, increasing their awareness, growth of “self-confidence to their capabilities” in taking care of the newborn [ 18 ], and finally, reduction of hospitalization period of the newborn and increasing parents' satisfaction [ 19 ]. Once discharged from the hospital, health care professionals’ support is less available for mothers; instead, informal support plays an essential role within the family [ 20 ].…”