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You Can’t Take Your Baby Home Yet: A Longitudinal Study of Psychological Symptoms in Mothers of Infants Hospitalized in the NICU

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Abstract

Evidence suggests that mothers of infants hospitalized in the Neonatal Intensive Care Unit (NICU) experience elevated rates of psychological symptoms. However, previous studies of this population have been mainly cross-sectional and have focused on very preterm infants. Although moderate- to late-preterm infants generally thrive, the possible psychological toll on their mothers has not yet been sufficiently examined. In the current study, we used a longitudinal design to investigate whether mothers of moderate- to late-preterm infants experience elevated rates of psychological symptoms during the infant’s hospitalization in the NICU and 6 months later. Results indicated that these mothers did show elevated depression, anxiety, and PTSD symptoms, and that symptom levels were similar in mothers of moderate- versus late-preterm infants. Mothers of moderate- to late-preterm infants hospitalized in the NICU appeared to experience these symptoms steadily over a 6-month period after giving birth. These findings suggest a need for greater support for these mothers while in the NICU.

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References

  • Barclay, L., Everitt, L., Rogan, F., Schmied, V., & Wyllie, A. (1997). Becoming a mother: An analysis of women’s experience of early motherhood. Journal of Advanced Nursing, 25, 719–728.

    Article  PubMed  CAS  Google Scholar 

  • Beck, C. T. (2003). Recognizing and screening for postpartum depression in mothers of NICU infants. Advanced Neonatal Care, 3(1), 37–46.

    Article  Google Scholar 

  • Beck, C. T., Gable, R. K., Sakala, C., & Declercq, E. R. (2011). Posttraumatic stress disorder in new mothers: Results from a two-stage U.S. National Survey. Birth, 38(3), 216–227.

    Article  PubMed  Google Scholar 

  • Braithwaite, M. (2008). Nurse burnout and stress in the NICU. Advances in Neonatal Care, 8(6), 343–347.

    Article  PubMed  Google Scholar 

  • Brandon, D. H., Tully, K. P., Silva, S. G., Malcolm, W. F., Murtha, A. P., Turner, B. S., & Holditch-Davis, D. (2011). Emotional responses of mothers of late-preterm and term infants. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40(6), 719–731.

    Article  Google Scholar 

  • Carter, J. D., Mulder, R. T., Bartram, A. F., & Darlow, B. A. (2005). Infants in a neonatal intensive care unit: Parental response. Archives of Disease in Childhood, Fetal and Neonatal Edition, 90(2), F109–F113.

    Article  PubMed  CAS  Google Scholar 

  • Cummings, E. M., & Davies, P. T. (1994). Maternal depression and child development. Journal of Child Psychology and Psychiatry, 35(1), 73–112.

    Article  PubMed  CAS  Google Scholar 

  • Davis, L., Edwards, H., Mohay, H., & Wollin, J. (2003). The impact of very premature birth on the psychological health of mothers. Early Human Development, 73(1), 61–70.

    Article  PubMed  Google Scholar 

  • Doering, L. V., Moser, D. K., & Dracup, K. (2000). Correlates of anxiety, hostility, depression, and psychosocial adjustment in parents of NICU infants. Neonatal Network, 19(5), 15–23.

    Article  PubMed  CAS  Google Scholar 

  • Engle, W. A. (2006). A recommendation for the definition of “late preterm” (near-term) and the birth weight–gestational age classification system. Seminars in Perinatology, 30(1), 2–7.

    Article  PubMed  Google Scholar 

  • Engle, W. A., Tomashek, K. M., Wallman, C., & The Committee on Fetus and Newborn (2007). “Late-preterm” infants: A population at risk. Pediatrics, 120, 1390–1401.

    Article  PubMed  Google Scholar 

  • Forbes, D., Creamer, M., & Biddle, D. (2001). The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD. Behaviour Research and Therapy, 39(8), 977–986.

    Article  PubMed  CAS  Google Scholar 

  • Fuchs, K., & Gyamfi, C. (2008). The influence of obstetric practices on late prematurity. Clinics in Perinatology, 35(2), 343–360.

    Article  PubMed  Google Scholar 

  • Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 5(1), 1071–1083.

    Article  Google Scholar 

  • Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008). Epidemiology and causes of preterm birth. The Lancet, 371(9606), 75–84.

    Article  Google Scholar 

  • Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27.

    Article  PubMed  Google Scholar 

  • Holditch-Davis, D., Bartlett, T. R., Blickman, A. L., & Miles, M. S. (2003). Posttraumatic stress symptoms in mothers of premature infants. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 32(2), 161–171.

    Article  Google Scholar 

  • Kohout, F. J., Berkman, L. F., Evans, D. A., & Cornoni-Huntley, J. (1993). Two shorter forms of the CES-D Depression Symptoms Index. Journal of Aging and Health, 5(2), 179–193.

    Article  PubMed  CAS  Google Scholar 

  • Lefkowitz, D. S., Baxt, C., & Evans, J. R. (2010). Prevalence and correlates of posttraumatic stress and postpartum depression in parents of infants in the Neonatal Intensive Care Unit (NICU). Journal of Clinical Psychology in Medical Settings, 17(3), 230–237.

    Article  PubMed  Google Scholar 

  • Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care, 46(3), 266–274.

    Article  PubMed  Google Scholar 

  • Martin, J. A., Hamilton, B. E., Osterman, M. J. K., Curtin, S. C., & Mathews, T. J. (2015). Births: Final data for 2013. National Vital Statistics Reports, 64(1), 1–65.

    PubMed  Google Scholar 

  • Martin, J. A., Kung, H. C., Matthews, T. J., Hoyert, D. L., Strobino, D. M., Guyer, B., & Sutton, S. R. (2006). Annual summary of vital statistics. Pediatrics, 121(4), 788–801.

    Article  Google Scholar 

  • Matthey, S., Barnett, B., Howie, P., & Kavanagh, D. J. (2003). Diagnosing postpartum depression in mothers and fathers: Whatever happened to anxiety? Journal of Affective Disorders, 74(2), 139–147.

    Article  PubMed  Google Scholar 

  • Melamed, N., Klinger, G., Tenenbaum-Gavish, K., Herscovici, T., Linder, N., Hod, M., & Yogev, Y. (2009). Short-term neonatal outcome in low-risk, spontaneous, singleton, late preterm deliveries. Obstetrics & Gynecology, 114(2), 253–260.

    Article  Google Scholar 

  • National Center for PTSD. (2016). PTSD Checklist for DSM-5 (PCL-5). Retrieved October 11, 2017 from http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp.

  • Nyström, K., & Axelsson, K. (2002). Mothers’ experience of being separated from their newborns. Journal of Obstetrics, Gynecologic, & Neonatal Nursing, 31(3), 275–282.

    Article  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.

    Article  Google Scholar 

  • Roberts, R. E., Rhoades, H. M., & Vernon, S. W. (1990). Using the CES-D scale to screen for depression and anxiety: Effects of language and ethnic status. Psychiatry Research, 31(1), 69–83.

    Article  PubMed  CAS  Google Scholar 

  • Ross, L. E., McLean, L. M., & Psych, C. (2006).Anxiety disorders during pregnancy and the postpartum period: A systematic review. Depression, 6(9), 1–14.

    Google Scholar 

  • Shapiro-Mendoza, C. K., & Lackritz, E. M. (2012). Epidemiology of late and moderate preterm birth. Seminars in Fetal & Neonatal Medicine, 17(3), 120–125.

    Article  Google Scholar 

  • Shapiro-Mendoza, C. K., Tomashek, K. M., Kotelchuck, M., Barfield, W., Nannini, A., Weiss, J., & Declercq, E. (2008). Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatrics, 121(2), 223–232.

    Article  Google Scholar 

  • Shaw, R. J., Deblois, T., Ikuta, L., Ginzburg, K., Fleisher, B., & Koopman, C. (2006). Acute stress disorder among parents of infants in the neonatal intensive care nursery. Psychosomatics, 47(3), 206–212.

    Article  PubMed  Google Scholar 

  • Söderquist, J., Wijma, B., & Wijma, K. (2006). The longitudinal course of post-traumatic stress after childbirth. Journal of Psychosomatic Obstetrics & Gynecology, 27(2), 113–119.

    Article  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.

    Article  PubMed  Google Scholar 

  • Stark, A. R. (2004). Levels of neonatal care. Pediatrics, 114, 1341–1347.

    Article  PubMed  Google Scholar 

  • Voegtline, K. M., & Stifter, C. A. (2010). Late-preterm birth, maternal symptomatology, and infant negativity. Infant Behavior and Development, 33(4), 545–554.

    Article  PubMed  Google Scholar 

  • Wang, M. I., Dorer, D. J., Fleming, M. P., & Catlin, E. A. (2004). Clinical outcomes of near-term infants. Pediatrics, 114, 372–376.

    Article  PubMed  Google Scholar 

  • Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD checklist: Reliability, validity, & diagnostic utility. Paper presented at Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, TX.

  • Wenzel, A., Haugen, E. N., Jackson, L. C., & Brendle, J. R. (2005). Anxiety symptoms and disorders at eight weeks postpartum. Journal of Anxiety Disorders, 19(3), 295–311.

    Article  PubMed  Google Scholar 

  • Wigert, H., Johansson, R., Berg, M., & Hellström, A. L. (2006). Mothers’ experiences of having their newborn child in a neonatal intensive care unit. Scandinavian Journal of Caring Sciences, 20(1), 35–41.

    Article  PubMed  Google Scholar 

  • Woody, C. A., Ferrari, A. J., Siskind, D. J., Whiteford, H. A., & Harris, M. G. (2017). A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders, 219, 86–92.

    Article  PubMed  CAS  Google Scholar 

  • Zanardo, V., Gambina, I., Begley, C., Litta, P., Cosmi, E., Guistardi, A., & Trevisanuto, D. (2011). Psychological distress and early lactation performance in mothers of late preterm infants. Early Human Development, 87(4), 321–323.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Teachers College, Columbia University, 525 West 120th Street, Box 102, New York, NY, 10027, USA

    Jenny H. Lotterman & George A. Bonanno

  2. Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    John M. Lorenz

Authors
  1. Jenny H. Lotterman
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  2. John M. Lorenz
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  3. George A. Bonanno
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Correspondence to Jenny H. Lotterman.

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Conflict of interest

The authors Jenny H. Lotterman, John M. Lorenz, and George A. Bonanno declares that they have no conflict of interest.

Ethical Approval

All procedures were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

was obtained from all individual participants included in the study.

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Lotterman, J.H., Lorenz, J.M. & Bonanno, G.A. You Can’t Take Your Baby Home Yet: A Longitudinal Study of Psychological Symptoms in Mothers of Infants Hospitalized in the NICU. J Clin Psychol Med Settings 26, 116–122 (2019). https://doi.org/10.1007/s10880-018-9570-y

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  • DOI: https://doi.org/10.1007/s10880-018-9570-y

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