Evolution of Depression and Anxiety Symptoms in Parents of Very Preterm Infants During the Newborn Period

Abstract

IMPORTANCE Mothers experience heightened depression and anxiety following very preterm (VPT) birth, but how these symptoms evolve during the first months after birth is unknown. Research on the psychological adjustment of fathers following VPT birth is limited. OBJECTIVES To describe the trajectory and predictors of distress in parents of VPT infants during the first 12 weeks after birth, and to compare rates of depression and anxiety in parents of VPT infants with those in parents of healthy full-term (FT) infants shortly after birth and at 6 months' postnatal age. DESIGN, SETTING, AND PARTICIPANTS Longitudinal, prospective, follow-up cohort study of depression and anxiety symptoms in parents of VPT infants (<30 weeks' gestational age; admitted to the neonatal intensive care unit at the Royal Women's Hospital, Melbourne, Australia, between January 21, 2011, and December 23, 2013), documented every 2 weeks until age 12 weeks and at age 6 months, as well as in parents of healthy FT infants (Ն37 weeks' gestational age; birth weight >2499 g; born at the Royal Women's Hospital between August 15, 2012, and March 26, 2014; not admitted to the neonatal nursery) shortly after birth and at age 6 months. EXPOSURE Birth of a VPT infant. MAIN OUTCOMES AND MEASURES Symptoms of depression (Center for Epidemiological Studies Depression Scale) and anxiety (Hospital Anxiety and Depression Scale). RESULTS The study included 113 mothers (mean [SD] age at birth, 32.7 [5.3] years) and 101 fathers (mean [SD] age at birth, 34.7 [6.4] years) of 149 VPT infants (49% male; 84 singletons, 65 multiples; mean [SD] birth weight, 1021 [261] g) as well as 117 mothers (mean [SD] age at birth, 32.9 [4.8] years) and 110 fathers (mean [SD] age at birth, 35.9 [5.3] years) of 151 healthy FT infants (50% male; 149 singletons, 2 multiples; mean [SD] birth weight, 3503 [438] g). Mean scores and rates of depression and anxiety reduced over time for parents of VPT infants in the 12 weeks after birth: the mean (95% CI) change in depression score per week was −0.52 (−0.73 to −0.31; P < .001) for mothers and −0.39 (−0.56 to −0.21; P < .001) for fathers; the mean (95% CI) change in anxiety score per week was −0.16 (−0.26 to −0.05; P = .003) for mothers and −0.22 (−0.31 to −0.15; P < .001) for fathers. However, rates never dropped below 20%. Few perinatal or social risk factors predicted longitudinal changes in depression or anxiety. Compared with parents of FT infants, parents of VPT infants had higher rates of depression shortly after birth

Parental experiences of family‐centred care from admission to discharge in the neonatal intensive care unit

“…One of the prevalent themes concerned the role of fathers in NICU, which has only recently become a focus of research in its own right . A recent study found similar rates of anxiety and depression in mothers and fathers of premature infants admitted to NICU, demonstrating that fathers need as much support as mothers. Both fathers as well as mothers emphasised how they were negatively affected by the perception that fathers’ roles are considered secondary in the NICU.…”

Transition to parenthood in the neonatal care unit: a qualitative study and conceptual model designed to illuminate parent and professional views of the impact of webcam technology

“…[8, 40]). Importantly, recent research has also demonstrated the emotional impact on fathers [12]. Parents of children who are very sick or premature often struggle with the uncertainty associated with their child’s short and longer term prognosis and the highly technical and somewhat ‘alien’ environment of the neonatal unit [41].…”

“…As a consequence, the “transition” of fathers, as they seek to establish a relationship with the new baby and support their partner, has increasingly been explored [11]. While research on the psychological adjustment of fathers of children admitted to NNU is limited, elevated rates of depression and anxiety have been identified [12]. Also, similar to their partner, periods of enforced separation from their new-born baby can function as a barrier to the establishment of the early parent-child relationship [8].…”

The role of social risk in an early preventative care programme for infants born very preterm: a randomized controlled trial

“…3,4 Parents of children born preterm are also at risk of poorer mental health, with both mothers and fathers reported to have elevated symptoms of anxiety and depression compared with parents of healthy term-born peers during the newborn period and into early childhood. 1,5 Whereas children born very preterm and their families are a heterogeneous group, with variable neurodevelopmental and mental health outcomes, there are several risk factors known to adversely affect child development and parental well-being, including medical, social, and environmental factors. 6,7 Medical factors such as brain injury and respiratory disease in infants born preterm are well-known risk factors for adverse developmental outcomes.…”