The Prevalence of PTSD of Mothers and Fathers of High-Risk Infants Admitted to NICU: A Systematic Review

McKeown, Lisa; Burke, Kylie; Cobham, Vanessa E.; Kimball, Hayley; Foxcroft, Katie; Callaway, Leonie

doi:10.1007/s10567-022-00421-4

Cited by 16 publications

(7 citation statements)

References 70 publications

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“…Having a baby hospitalised in a neonatal intensive care unit (NICU) is a distressing and traumatic experience for parents. [1][2][3][4][5][6] A growing body of literature shows that, compared with parents of well babies, parents of infants hospitalised in the NICU are at higher risk to suffer from several mood and mental disorders, ranging from post-traumatic stress disorder, acute-stress disorder, depression and anxiety. [1][2][3][4][5][6] When parents in the NICU are distressed or depressed, their interactions with their infants may be less sensitive and attuned to their infant's needs.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6] A growing body of literature shows that, compared with parents of well babies, parents of infants hospitalised in the NICU are at higher risk to suffer from several mood and mental disorders, ranging from post-traumatic stress disorder, acute-stress disorder, depression and anxiety. [1][2][3][4][5][6] When parents in the NICU are distressed or depressed, their interactions with their infants may be less sensitive and attuned to their infant's needs. This in turn may interfere with the social, emotional, cognitive and physical development of these already vulnerable infants.…”

Section: Introductionmentioning

confidence: 99%

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Parental stress, depression, anxiety and participation in care in neonatal intensive care unit: a cross-sectional study in Italy comparing mothers versus fathers

Bua,

Dalena,

Mariani

et al. 2024

bmjpo

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BackgroundThis study aimed at documenting the levels of stress, depression, anxiety and participation in care among mothers versus fathers of newborns hospitalised in a third-level neonatal intensive care unit (NICU) in Northern Italy.MethodsParental stress, depression and anxiety were assessed by the Parental Stressor Scale in NICU (PSS:NICU), the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). Participation in care was evaluated with the Index of Parental Participation. Differences between mothers and fathers were assessed with the Mood’s median test and z-test, respectively for continuous and discrete variables. Multivariate analyses controlling for potential confounders were performed to confirm gender differences.Results191 parents (112 mothers and 79 fathers) were enrolled. Mothers reported significantly higher median scores for stress (2.9 vs 2.2, p<0.001) and trait anxiety (37 vs 32, p=0.004) and higher depression rates (EPDS ≥12: 43.8% vs 19.0%, p<0.001). ‘High stress’ (PSS:NICU ≥3) was reported by 45.5% of mothers compared with 24.1% of fathers (p=0.004). The frequency of the three conditions simultaneously was significantly higher among mothers (20.0% vs 3.8%, p=0.016), with the vast majority of mothers (76.0%) suffering from at least one condition compared with less than half of fathers (45.3%, p<0.001). Participation in care was more frequent in mothers (median score: 19 vs 15, p<0.001), with the exception of activities related to advocacy (median 5 vs 4, p=0.053). In a multivariate analysis, gender differences in mental health outcomes did not change.ConclusionsRoutine screening of mental distress among parents of infants in NICU is warranted, and gender differences need to be acknowledged in order to deliver tailored support and to promote collaboration with the family of vulnerable newborns. Knowledge and skills on how to prevent and cope with mental distress of parents should be part of the core curriculum of staff working in NICU.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Parental stress, depression, anxiety and participation in care in neonatal intensive care unit: a cross-sectional study in Italy comparing mothers versus fathers

Bua,

Dalena,

Mariani

et al. 2024

bmjpo

View full text Add to dashboard Cite

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“…On the other hand, the prevalence of PTSD in the mothers of infants admitted to the NICU ranges around 40% according to previous studies [ 26 , 27 ]. Although there is great complexity among NICUs, as they consist of many departments comprising different levels of care (e.g., very seriously ill neonates or very premature, intermediate, and mild neonatal illness), parental stress appears to be high with respect to different departments and countries [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

The Relation between Neonatal Intensive Care Units and Postpartum Post-Traumatic Stress Disorder after Cesarean Section

Orovou

Eskitzis

Mrvoljak-Theodoropoulou

et al. 2023

Healthcare

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Background: The experience of a neonate hospitalized in the NICU is an understandably traumatic experience for parents, especially for the mothers of neonates. This mental distress resulting from preterm birth and/or NICU hospitalization can be understood as post-traumatic symptomatology, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 version). The aim of this study is to investigate the impact of the admission of a neonate to the NICU (forany reason) on the development of postpartum PTSD in a sample of women after cesarean section. Methods: A total of 469 women who gave birth with cesarean section from July 2019 to June 2020 participated in this study out of the original sample of 490 women who consented to participate. Data were obtained from the researcher’s socio-demographic questionnaire and the post-traumatic stress checklist (PCL-5) from the Diagnostic and Statistical Manual of Mental Disorders DCM-5 version. Results: In total, 11.7% of the sample experienced postpartum PTSD. There is a strong relationship between the inclusion of a neonate to the NICU due to perinatal stress, breathing difficulties, infections, and IUGR with postpartum PTSD (37.7%) in relation to the perinatal stress Criterion A (fear for the life of the neonate), the first criterion of postpartum PTSD. Conclusions: Additional measures must be taken for mothers of children who have been admitted to the neonatal intensive care unit with psychological support interventions and a reassessment of their mental state.

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Over 4 decades of research has established that infant neonatal intensive care unit (NICU) hospitalization increases maternal risk for psychological distress, including greater anxiety and stress, depression, and acute and posttraumatic stress disorders (ASD and PTSD). [1][2][3] Maternal psychological distress may negatively impact motherinfant bonding and result in adverse long-term child developmental outcomes. 4,5 NICU infants are at heightened risk for adverse development outcomes due to their increased developmental vulnerability and exposure to NICU environmental factors known to alter nervous system organization (eg, sensory overstimulation, parental separation, repeated medical/surgical procedures, and pain).

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mentioning

confidence: 99%

“…Over 4 decades of research has established that infant neonatal intensive care unit (NICU) hospitalization increases maternal risk for psychological distress, including greater anxiety and stress, depression, and acute and posttraumatic stress disorders (ASD and PTSD) 1-3. Maternal psychological distress may negatively impact mother–infant bonding and result in adverse long-term child developmental outcomes 4,5.…”

mentioning

confidence: 99%

Parenting Expectations, NICU Experiences, and Maternal Psychological Outcomes

Rodrigues,

Shin,

Pinto

et al. 2024

Advances in Neonatal Care

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Background: Infant neonatal intensive care unit (NICU) hospitalization increases maternal risk for psychological distress. However, no universal screening standards exist and predicting maternal risk remains challenging. Reconceptualizing maternal distress in relation to differences between parenting expectations and NICU experiences may illuminate commonalities across a range of experiences. Purpose: This study explored parenting expectation–experience differences (EEDs) among NICU mothers and assessed correlations between EED scores and psychological outcomes 1 to 5 years post-NICU hospitalization. Methods: A 3-phase explanatory sequential mixed-methods design was used. Pearson's correlation coefficients were used to measure relationships between EED scores and maternal psychological outcomes. Reflexive thematic analysis of one-on-one, semi-structured interviews contextualized EED scores. Results: Most participants (92.9%) reported negative EED scores, indicating NICU experiences fell short of parenting expectations. Significant inverse correlations were found between EED scores and maternal outcomes, including depression (r = −0.25, P< .01), anxiety (r = −0.25, P < .01) and posttraumatic stress disorder symptoms (r = −0.41, P < .001), and perceived parenting self-efficacy (r = −0.28, P < .01). Major qualitative themes included unexpected versus prepared, lost parenting experiences, and surviving and thriving. Data synthesis contextualized EED scores and revealed key differences in meaning ascribed to unmet parenting expectations. Implications for Practice and Research: Preparing mothers for infant NICU hospitalization and creating a NICU parenting environment, which better supports mothers and their engagement in parenting tasks, may help to reduce differences between parenting expectations and NICU experiences. Further research is needed to elucidate the impacts of parenting EEDs in this population.

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The Prevalence of PTSD of Mothers and Fathers of High-Risk Infants Admitted to NICU: A Systematic Review

Cited by 16 publications

References 70 publications

Parental stress, depression, anxiety and participation in care in neonatal intensive care unit: a cross-sectional study in Italy comparing mothers versus fathers

Parental stress, depression, anxiety and participation in care in neonatal intensive care unit: a cross-sectional study in Italy comparing mothers versus fathers

The Relation between Neonatal Intensive Care Units and Postpartum Post-Traumatic Stress Disorder after Cesarean Section

Parenting Expectations, NICU Experiences, and Maternal Psychological Outcomes

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