Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis

Abstract

Background: Neonatal intensive care unit (NICU) admission causes significant distress that can hinder the successful transition into parenthood, child-parent relations, and child development.Purpose: This systematic review and meta-analysis aimed to understand parental psychological phenomena. Here we assessed the emotional response of parents of newborns during NICU admission.Methods: Two authors independently searched the PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Clinical Key, and Google Scholar databases for studies published between January 01, 2004, and December 31, 2021. The review followed Cochrane collaboration guidelines and the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement. The quality of the included studies was assessed using the modified Newcastle-Ottawa Scale. Stata software (version 16) was used to compute the results.Results: This review comprised 6,822 parents (5,083 mothers, 1,788 fathers; age range, 18–37 years) of NICU patients. The gestational ages and neonatal weights were 25.5–42 weeks and 750–2,920 g, respectively. The pooled prevalence of anxiety was higher among mothers (effect size [ES], 0.51; 95% confidence interval [CI], 0.41–0.61; and heterogeneity [I2]=97.1%; P<0.001) than among fathers (ES, 0.26; 95% CI, 0.11–0.42; I2=96.6%; P<0.001). Further, the pooled prevalence of depression was higher among mothers (ES, 0.31; 95% CI, 0.24–0.38; I2=91.5%; P<0.001) than among fathers (ES, 0.12; 95% CI, 0.03–0.22; I2=85.6%; P<0.001). Similarly, the pooled prevalence of stress was higher among mothers (ES, 0.41; 95% CI, 0.31–0.51; I2= 93.9%; P<0.001) than among fathers (ES, 0.22; 95% CI, 0.09–0.34; I2=85.2%; P<0.001).Conclusion: NICU admission is more stressful for mothers than fathers and can affect mental health and quality of life. Mothers reported a higher pooled prevalence of stress, anxiety, and depression than fathers, possibly attributable to their feelings about birthing a sick child.

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

“…These prevalences are in line with Shetty et al systematic review that found in the NICU setting a pooled prevalence of stress of 41% among mothers versus 22% in fathers. 13 When looking at depression and anxiety, results of our study showed that both conditions were more frequent in mothers, though significantly so for depression and trait anxiety. These results are to a large extent aligned with previous studies, although again literature is not fully consistent.…”

“…In line with our study, a recent systematic review found that in the NICU setting, the pooled prevalence of stress, anxiety and depression is significantly higher among mothers than fathers. 13 Overall, our findings suggest that more attention should be given to the mental health of parents of infants hospitalised in the NICU, particularly to mothers, who are more directly involved in newborn care. This includes the need for more studies, to better describe differences in mental health indicators and participation in care among mothers and fathers in different settings and to describe tailored interventions, both in support of parents and staff.…”

“…These prevalences are in line with Shetty et al systematic review that found in the NICU setting a pooled prevalence of stress of 41% among mothers versus 22% in fathers. 13 …”

“… 31 Shetty et al found in a meta-analysis of 40 studies, that pooled prevalence of both depression and anxiety were higher among mothers than fathers. 13 …”

“…31 Shetty et al found in a meta-analysis of 40 studies, that pooled prevalence of both depression and anxiety were higher among mothers than fathers. 13 While it is plausible that differences among fathers and mothers are to some extent setting specific and, therefore, need to be estimated for each setting, gender differences in psychological distress as well as the role of father in newborn care need to be acknowledged by all NICU staff and taken into account during daily clinical work. Although in our study, fathers experienced less frequently stress, anxiety and depressive symptoms, they were far to be immune from them.…”