Abstract
BackgroundSeveral studies have reported significantly higher stress levels, both short and long terms, among mothers giving preterm birth compared with mothers giving birth at term. Stress, however, is a psychological phenomenon that may present as anxiety, depression and/or trauma reactions. In this study, the long-term mental health outcomes and the prevalence of anxiety, depression and trauma reactions in women experiencing preterm birth were explored. Interactional, main effect variables and predictors were identified.MethodsTwenty-nine mothers of 35 premature children born before the 33rd week of pregnancy were assessed within 2 weeks postpartum (T0), 2 weeks after hospitalization (T1), 6 months post-term (T2), and 18 months post-term (T3). The standardized psychometric methods Impact of Event Scale (IES), General Health Questionnaire (GHQ) and State Anxiety Inventory (STAI-X1) assessed the maternal mental health outcomes.ResultsThe maternal mental health problems except state anxiety decreased from T0 to T1, but remained high and stable at T3. The prevalence of posttraumatic stress reactions (PTSR) and posttraumatic stress disorder (PTSD) at T0 and T3 was 52% and 23%, respectively. We identified the time period between T0 and T1 to have a significant main effect on mental health outcomes. The predictors of higher levels of mental health problems were preeclampsia, previous psychological treatment, age, trait anxiety and infant's postnatal intraventricular haemorrhage. Bleeding in pregnancy predicted lower levels of mental health problems.ConclusionsThe prevalence of maternal mental health problems remained high, emphasizing the importance of effective interventions.
Highlights
Substantial psychological distress may be caused in mothers by the experience of giving preterm birth and successive experiences in the neonatal intensive care unit (NICU)
After a significant decrease from T0 to T1, we found high and prolonged levels of maternal mental health problems following preterm birth
One interesting result in this study is the high prevalence of posttraumatic stress disorder (PTSD) of 28 % at the last point of measurement, T3
Summary
Substantial psychological distress may be caused in mothers by the experience of giving preterm birth and successive experiences in the neonatal intensive care unit (NICU). Knowledge about long-term effects of a preterm birth is valuable to maternity units for implementation in the prevention of mental health problems postpartum. Several studies from the past decades have explored maternal mental health problems following preterm birth, both in the short and long terms [1,2,3,4,5,6,7,8,9]. Maternal postpartum stress reactions have been the main research focus in these studies [2,8,9,10], which have reported that women with preterm deliveries experience significantly higher levels of stress than women with term deliveries [2,8]. The long-term mental health outcomes and the prevalence of anxiety, depression and trauma reactions in women experiencing preterm birth were explored.
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