Screening for Symptoms of Postpartum Traumatic Stress in a Sample of Mothers with Preterm Infants

Shaw, Richard J.; Lilo, Emily; Storfer‐Isser, Amy; Ball, Michelle; Proud, Melinda S.; Vierhaus, Nancy S.; Huntsberry, Audrey; Mitchell, Kelley; Adams, Marian M.; Horwitz, Sarah M.

doi:10.3109/01612840.2013.853332

Cited by 35 publications

(41 citation statements)

References 37 publications

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“…In a recent study of mothers of premature infants (N=135), investigators found that maternal sociodemographic factors as well as the infant's physiologic stability did not contribute to early identification of postpartum traumatic stress in the Neonatal Intensive Care Unit (NICU). 2 These findings differ slightly from another study of parental stress (N=100) in the NICU, in that older parents and interruption of breast feeding plans were associated with higher stress levels but not necessarily postpartum traumatic stress.…”

Section: Introductioncontrasting

confidence: 56%

“…The fact that 24.1% of the infants were admitted to the NICU with only three NICU stays 7 days or longer suggests that this sample does not represent the very low birth weight infants described in research that associates post-traumatic stress experiences with families that take up to a year to mend. 2,5 Because the results of this study illustrate a lasting, unresolved stress for all families with infants admitted to the NICU (r=.88), one must question how even the short stays in the NICU result in similar emotions. The longitudinal Swedish study of Hildingsson and Thomas may offer some answers; these researchers found that even if a woman perceived her pregnancy, birth or transition home as stressful, regardless of actual circumstances, which this stress lasted up to one year.…”

Section: Discussionmentioning

confidence: 99%

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Stress beyond the Neonatal Intensive Care Unit (NICU) Discharge: Implications to Outcome

Johnson¹

2016

Pediatr Neonatal Nurs Open J

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Purpose: The high-risk parental experience in the neonatal intensive care environment is a major stress event that is not necessarily resolved with discharge. Many parents report "walking on eggshells" with worry and stress for up to a year beyond the birth of their infant. Because stressors can induce behavioral, physiological, and biochemical changes to such a degree that family adaptation is challenged, attempting to resolve stressors before the discharge should be a goal. The ethical concept of beneficence (doing good) provides the Neonatal Intensive Care Unit (NICU) nurse with a framework for wanting to lower stressors as much as possible prior to discharge. The purpose of this study was to examine the relationship between high-risk experiences including high-risk pregnancies, deliveries, and NICU admissions and unresolved parental stress up to a year after delivery. Method: Women in a day care center with infants under a year old were tested for their emotional status and pregnancy related demographics. Principal Results: Findings show a positive correlation between two factors, both NICU admission of a newborn and parental stress (r=.88) and a high risk primiparous births without NICU admissions and parental stress (r=.72). Major Conclusion: While this is a pilot study, the findings illustrate unresolved parental stress well beyond the birth of the baby, providing ethical support for early identification of stressed parents and interventions to normalize that stress before discharge. When parents report significant stress after their deliveries or infants' NICU admissions, and there is no specific intervention to identify and reduce this stress, high levels of stress may last and be measurable even a year later.

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Section: Introductioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Stress beyond the Neonatal Intensive Care Unit (NICU) Discharge: Implications to Outcome

Johnson¹

2016

Pediatr Neonatal Nurs Open J

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“…In relation to the prevalence of depressive symptoms among caregivers of NBIs hospitalized in the NICU, prior studies reported a 10-59% prevalence. 1,6,7,9,12,19 In our population, the prevalence was close to the lower limit of this range in both measurements.…”

Section: Discussionmentioning

confidence: 85%

Depressive symptoms and associated factors in caregivers of newborn infants hospitalized in a neonatal intensive care unit

et al. 2017

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Introduction.A high prevalence of depressive symptoms has been reported in family members of newborn infants hospitalized in neonatal intensive care units. This causes a high negative impact on the newborn infant-family bond. Objective. To establish the prevalence of depressive symptoms and their associated factors in caregivers of newborn infants hospitalized in a neonatal intensive care unit in Colombia. Materials and Methods. Cross-sectional, analytical study conducted at a tertiary care health facility specialized in cardiovascular disease. The Beck Depression Inventory-II was administered upon admission to the NICU and on Day 8. Depressive symptoms were considered present if caregivers had intermittent, moderate, severe, or extreme depression. Bivariate and multivariate analyses were done using binomial regression models. Results. A total of 107 children and their caregivers were studied. The prevalence of depressive symptoms was 20.56% (95% confidence interval [CI]: 12.77-28.34) at baseline and 12.86% (95% CI: 4.1-20.89) on Day 8. Male caregivers and caregivers older than 30 years old had a lower risk of having depressive symptoms whereas being the head of the household, having completed primary education or no education at all, and having a baby with an Apgar score at birth of 1-6 were risk factors for developing depressive symptoms. Conclusions. The prevalence of depressive symptoms was high. Being the head of the household, having a low level of education, and an Apgar score at birth of 1-6 were associated with depressive symptoms among caregivers.

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“…Parents of preterm babies report more perceived stress and experience more adjustment difficulties and need for support during the first year after delivery compared to parents of infants born at term (7,8). It has been documented that parents may experience severe psychological distress, such as posttraumatic stress reactions and depression following the preterm birth of their baby, which subsequently may impact on the mother-infant-interactions and their attachment relationship (9)(10)(11)(12)(13)(14). In turn, poorer parenting competencies, such as lack of sensitivity during interactions may affect the infant's development (15).…”

Section: Introductionmentioning

confidence: 99%

Improving Maternal Mental Health Following Preterm Birth Using an Expressive Writing Intervention: A Randomized Controlled Trial

Horsch¹,

Tolsa²,

Gilbert³

et al. 2015

Child Psychiatry Hum Dev

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Evaluations of evidence-based, easily accessible, psychological interventions to improve maternal mental health following very preterm birth are scarce. This study investigated the efficacy and acceptability of the expressive writing paradigm for mothers of very preterm infants. The level of maternal posttraumatic stress and depressive symptoms was the primary outcome. Participants were 67 mothers of very preterm babies who were randomly allocated into the intervention (expressive writing; n = 33) or control group (treatment-as-usual; n = 32) when their infant was aged 3 months (corrected age, CA). Measurements were taken 3 months (preintervention), 4 months (post-intervention), and 6 months CA (follow-up). Results showed reduced maternal posttraumatic stress (d=0.42), depressive symptoms (d=0.67), and an improved mental health status (d=1.20) in the intervention group, which were maintained at follow-up.Expressive writing is a brief, cost-effective, and acceptable therapeutic approach that could be offered as part of the NICU care.

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Screening for Symptoms of Postpartum Traumatic Stress in a Sample of Mothers with Preterm Infants

Cited by 35 publications

References 37 publications

Stress beyond the Neonatal Intensive Care Unit (NICU) Discharge: Implications to Outcome

Stress beyond the Neonatal Intensive Care Unit (NICU) Discharge: Implications to Outcome

Depressive symptoms and associated factors in caregivers of newborn infants hospitalized in a neonatal intensive care unit

Improving Maternal Mental Health Following Preterm Birth Using an Expressive Writing Intervention: A Randomized Controlled Trial

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