Comparison of Psychosocial Adjustment of Mothers and Fathers of High-Risk Infants in the Neonatal Intensive Care Unit

Abstract

OBJECTIVE:To compare the psychosocial adjustment of mothers and fathers to the birth of a premature or critically ill infant hospitalized in the neonatal intensive care unit (NICU). STUDY DESIGN:Using a comparative design, we studied 165 mother and father pairs of highrisk neonates. Mothers were 29.1 Ϯ 6.7 and fathers were 30.7 Ϯ 6.8 years old. All infants were hospitalized in the NICU. Couples completed questionnaires in either English or Spanish during the infant's NICU stay. RESULTS:Mothers were more poorly adjusted and were more anxious, hostile, and depressed than fathers, but both parents experienced levels of emotional distress significantly above normative values. Mothers and fathers reported equal levels of family functioning and social support and shared similar feelings of control related to the health status of their infant. CONCLUSION:The birth of an infant who requires care in the NICU environment is highly stressful for both parents. Physicians, nurses, and other health professionals working in the NICU should assess the psychosocial adjustment in both parents, but mothers may require more intense education and counseling to reduce the distress they experience.More than 100,000 infants are admitted to neonatal intensive care units (NICUs) each year. 1 Both mothers and fathers of infants in the NICU face many uncertainties, including their infant's future, their reaction to the infant's birth, their ability to safeguard an infant at risk for cardiopulmonary arrest, and the financial impact of the infant's illness on the family. 2-7 The highly technical environment of the NICU can overwhelm parents and increase their perception that their baby is abnormal or vulnerable. 8 Because mothers have been the predominant focus of previous research, the purpose of the current study was to compare the psychosocial responses of mothers and fathers to the NICU hospitalization of their infant.Several researchers have identified specific aspects of the NICU environment that cause distress in parents. 4,9 However, a comparison of mothers' and fathers' stress in relation to the NICU has been the focus of only one study. Miles and colleagues 11 found that mothers reported the NICU to be more stressful than fathers did, and both found the environment more stressful during the first week of NICU hospitalization than 1 week later. Stress related to parental role alteration decreased more in mothers than in fathers. Paternal anxiety was related to adopting the parental role and to uncertainty related to the child's future. In contrast, maternal anxiety was more diffuse and not directly related to these factors. This study was limited by a small sample size (23 couples) and focused on a comparison of mothers' and fathers' anxiety rather than the broader area of psychosocial adjustment.Previous research related to parental psychosocial adaptation to the birth of a premature or critically ill infant has focused almost exclusively on mothers. 2,3,5,7 When both parents have been included, researchers have focused on the post...

Neonatal Research and the Validity of Informed Consent Obtained in the Perinatal Period

“…Obtaining a valid proxy consent in this situation may be compromised by maternal illness, stress of labor, medication administration, and separation from the infant after birth. 3,4 Previous research has shown poor validity of consent obtained from adult populations consenting for themselves to participate in clinical research. [5][6][7][8] Little research, however, has been carried out on the validity of consent from parents of sick neonates.…”

Experiences of having a prematurely born infant from the perspective of mothers in northern Sweden

“…Mothers of preterm infants often experience strain and depression in the early stages following the birth of the infants (8)(9)(10)(11). At the same time, feelings of disappointment (12) and failure are often experienced, based on the fact that the mothers were unable to complete the pregnancy (6).…”

A challenging intervention with maternal anxiety: Babies requiring surgical correction of a congenital anomaly after missed prenatal diagnosis

“…A hypothetical model of a normal sequence of parental reactions to the birth of a malformed infant has been described by Drotar et al (1975). Studies of anxiety and depression (Brooten et al, 1988;Catlett, Miles, & Holditch-Davis, 1994;Doering, Dracup, & Moser, 1999;Gennaro, 1985Gennaro, , 1988Meyer et al, 1995) have confirmed higher levels of anxiety and depression in mothers of premature babies. In fact, we felt that some characteristics of premature babies (which have been well described in the literature: Als et al, 1986;Brazelton, 1973;GarciaColl, 1990;Gorsky, Davison, & Brazelton, 1979;Medoff-Cooper, 1986;Minde et al, 1978;Tronick, Scanlon, & Scanlon, 1990), such as being less socially responsive and showing a low threshold of stimulation, might well apply to newborns requiring surgery at birth; these characteristics form the object of this study.…”