Maternal Stress, Depression, and Attachment in the Neonatal Intensive Care Unit Before and During the COVID Pandemic: An Exploratory Study.

Filippa Manuela,Maria Grazia Monaci,Maricé Pereira Camejo,Petra S Hüppi,Francisca Barcos-Munoz,Didier Grandjean,Cristina Borradori-Tolsa,Joana Sa De Almeida,Lara Lordier

doi:10.3389/fpsyg.2021.734640

Abstract

The main aim of the present study was to investigate the effects of the COVID-19 pandemic on the mothers’ postnatal depression, stress, and attachment during their stay in the Neonatal Intensive Care Unit (NICU). Twenty mothers of very premature infants born before 32weeks of gestational age were recruited at the Geneva University Hospital between January 2018 and February 2020 before the COVID-19 pandemic started. Mothers were screened for postnatal depression after their preterm infant’s birth (Edinburgh Postnatal Depression Scale, EPDS), then for stress (Parental Stressor Scale: Neonatal Intensive Care Unit, PSS:NICU), and attachment (Maternal Postnatal Attachment Scale, MPAS) at infant’s term-equivalent age. Data were compared with 14 mothers recruited between November 2020 and June 2021 during the COVID-19 pandemic. No significant differences were found in the scores for depression, stress, and attachment between the two groups. However, a non-statistically significant trend showed a general increase of depression symptoms in mothers during the COVID-19 pandemic, which significantly correlated to the attachment and stress scores. Moreover, the PSS:NICU Sights and Sounds score was significantly positively correlated with EPDS scores and negatively with the MPAS score only in the During-COVID group. To conclude, we discussed a possible dampened effect of the several protective family-based actions that have been adopted in the Geneva University Hospital during the health crisis, and we discussed the most appropriate interventions to support parents in this traumatic period during the COVID-19 pandemic.

Highlights

The COVID-19 pandemic has been shown to have important public health implications including emotional and social functioning, for populations at risk (Pfefferbaum and North, 2020)
We hypothesized that the COVID-19 pandemic could have a detrimental impact on maternal depression after birth, on maternal stress symptoms during their hospital stay in the neonatal intensive care unit (NICU), and, on maternal attachment at hospital discharge
The mean and standard deviations for the EPDS, PSS:NICU subscales, and Maternal Postnatal Attachment Scale (MPAS) are presented in Table 2 for both groups, Before- and During- COVID

Summary

Introduction

The COVID-19 pandemic has been shown to have important public health implications including emotional and social functioning, for populations at risk (Pfefferbaum and North, 2020). Higher levels of depression and symptoms of anxiety have been documented in the postnatal period since the beginning of the COVID-19 pandemic (Cameron et al, 2020; Davenport et al, 2020; Davis-Floyd et al, 2020; Ahmad and Vismara, 2021) During their child’s hospitalization in the neonatal intensive care unit (NICU), mothers of premature babies face the known stressors of premature birth and the issues related to the pandemic (Tscherning et al, 2020). The evident consequences of isolation measures included an increased risk of separation, stress, and depression for parents of preterm infants hospitalized in the NICUs. During periods of restricted visits to their hospitalized baby due to the COVID-19 pandemic, parents expressed psychological distress that could have detrimental effects on the parent–child relationship (van Veenendaal et al, 2021). NICU policies preserving 24-h parental presence decreased significantly (Mahoney et al, 2020), resulting in a reduction in therapeutic services (i.e., physiotherapy, music therapy, etc.), lactation interventions, and, more generally, in parenting support

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Conclusion