Abstract
BackgroundHaving a preterm newborn and the experience of staying in the neonatal intensive care unit (NICU) has the potential to impact a mother’s mental health and overall quality of life. However, currently there are few studies that have examined the association of acute post-traumatic stress (PTS) and depression symptoms and infant and maternal outcomes in low-income populations.Design/ methodsIn a cross-sectional study, we examined adjusted associations between positive screens for PTS and depression using the Perinatal Post-traumatic stress Questionnaire (PPQ) and the Patient Health-Questionnaire 2 (PHQ-2) with outcomes using unconditional logistic and linear regression models.ResultsOne hundred sixty-nine parents answered the questionnaire with 150 complete responses. The majority of our sample was Hispanic (68%), non-English speaking (67%) and reported an annual income of <$20,000 (58%). 33% of the participants had a positive PPQ screen and 34% a positive PHQ-2 screen. After adjusting for confounders, we identified that a positive PHQ-2 depression score was associated with a negative unit (95% CI) change on the infant’s Vineland Adaptive Behavior Scales, second edition of − 9.08 (− 15.6, − 2.6) (p < 0.01). There were no significant associations between maternal stress and depression scores and infant Bayley Scales of Infant Development III scores or re-hospitalizations or emergency room visits. However, positive PPQ and screening score were associated with a negative unit (95% CI) unit change on the maternal Multicultural Quality of Life Index score of − 8.1 (− 12, − 3.9)(p < 0.01) and − 7.7 (− 12, − 3) (p = 0.01) respectively.ConclusionsMore than one-third of the mothers in this sample screened positively for PTS and depression symptoms. Screening scores positive for stress and depression symptoms were associated with a negative change in some infant development scores and maternal quality of life scores. Thoughtful screening programs for maternal stress and depression symptoms should be instituted.
Highlights
Having a preterm newborn and the experience of staying in the neonatal intensive care unit (NICU) has the potential to impact a mother’s mental health and overall quality of life
A 150-item questionnaire with components validated in English and Spanish was administered to participants about life after discharge from the NICU
Maternal education and language were not associated with Perinatal Post-traumatic stress Questionnaire (PPQ) or Patient Health-Questionnaire 2 (PHQ-2) scores
Summary
Having a preterm newborn and the experience of staying in the neonatal intensive care unit (NICU) has the potential to impact a mother’s mental health and overall quality of life. Currently there are few studies that have examined the association of acute post-traumatic stress (PTS) and depression symptoms and infant and maternal outcomes in low-income populations. Many studies have evaluated the various emotional and mental health challenges that the mothers of neonates, both term and preterm, that can present at birth and in the first few years after NICU discharge [6, 7]. Of the studies that have assessed mental health outcomes in mothers of preterm neonates, most studies describe mental health perturbations like post-traumatic stress disorder (PTSD) and depression as being strongly associated with the birth of preterm infants [8,9,10,11,12,13,14,15]. Given that preterm neonates are a vulnerable population already with an increased risk of poor health outcomes, it becomes of the utmost importance to identify the factors that contribute to the development of poor mental health outcomes amongst their mothers
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