Maternal psychological distress and visitation to the neonatal intensive care unit

Abstract

Aim To examine associations between maternal NICU visitation rates, maternal psychological distress (“distress”), and preterm infant outcome post-NICU discharge in a contemporary cohort of very low birth weight (VLBW) infants. Methods This was a prospective study of 69 mothers and their VLBW infants. Distress was assessed 1 month post-birth, 2 weeks prior to NICU discharge and after NICU discharge at 4 months corrected age [CA]. Maternal NICU visitation rates were calculated for the first 2 weeks and 1 month post-birth as well as for the entire NICU hospitalization. Regression analyses adjusted for the impact of 1. maternal and infant characteristics and distress on maternal visitation rates and 2. the impact of visitation on long-term maternal distress, and rates of infant clinic attendance and rehospitalization. Results Greater number of children in the home, maternal exposure to a greater number of potentially traumatic events prior to childbirth, and lower maternal anxiety consistently predicted lower visitation rate. Lower maternal visitation rate predicted higher maternal depression scores at infants’ 4 month CA visit. Maternal NICU visitation rate did not predict post-NICU discharge infant clinic attendance or rehospitalization. Conclusion Distress is an important predictor of visitation. In turn, visitation is associated with long-term maternal distress.

Parents' presence and parent–infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries

“…In addition to increased holding, the parents’ presence increased as the infant got older. Earlier studies have reported that parents’ presence and visits reduced as the infant got older. This may suggest differences in the cultures and practices of the European units regarding parental support than older studies or different societies.…”

“…The rate of participation in this study was high, even in this vulnerable patient population, which shows how acceptable the diary method was. The diary data also made it possible to analyse the duration of presence and physical closeness, whereas most of the earlier studies only reported the number of visits or episodes of SSC .…”

Measuring Parental Presence in the Neonatal Intensive Care Unit

“…The presence of other children was the most common factor associated with a significant decrease in parental presence in the NICU, as reported by nine studies 26,[28][29][30][31][32][33][34][35] ; followed by extended distance to the hospital or other travel concerns, as reported by seven studies. 24,26,30,31,34,36,37 In four studies, parental presence increased when parents had the opportunity to stay with or close to their infant. 17,26,30,33 Also in four studies, increased presence was correlated with increased socioeconomic advantage.…”

“…Two studies found no association with infant medical or neurodevelopmental outcomes. 20,31 One study found a positive correlation between parental presence and infant neurobehavioral progress at term equivalent. 11 Another study associated paternal presence with increased infant adaptive behavior and personal-social development at 18 months.…”

Oxytocin trajectories and social engagement in extremely premature infants during NICU hospitalization

“…Researchers have reported that parents visit their infant in the NICU on average 21 hours per week during hospitalization (Franck & Spencer, 2003; Gonya & Nelin, 2013), and that infants are held on average 2 times per week (Reynolds et al, 2013). Thus, extremely premature infants experience the majority of the first months of life without their mother (Greene et al, 2015). The severely stressful social experience of maternal separation places the extremely premature infant at high risk for altered brain development and subsequent deficits in socioemotional skills (Montagna & Nosarti, 2016).…”