Abstract
Aim: This paper aimed to explore psychological functioning and mental representations in mothers of preterm infants during the child's hospitalization in a Neonatal intensive care unit (NICU).Methods: A sample including 62 mothers of premature infants (gestational age < 37 weeks) was recruited in a NICU. According to the gestational age at the time of delivery, we considered two groups: Group A included mothers whose children were born before 32 weeks of pregnancy; Group B included mothers whose children were born at or after 32 weeks of pregnancy.Within one week of childbirth, mothers were administered two self-report questionnaires: the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). When their infants' medical conditions became stable, the Clinical Interview for Parents of High-Risk Infants (CLIP) was administered to mothers.Results: The results showed high levels of depression and anxiety in both groups of mothers, with higher state anxiety scores in Group A than Group B. Besides, a series of hierarchical regression analyses were conducted with STAI, EPDS, and gestational age as predictors on the CLIP scores. Results indicated that EPDS scores predicted CLIP scores on parental self-image, support system, and readiness for discharge (p < 0.001); moreover, the interaction among depression, anxiety, and gestational age predicted the CLIP dimension of feeling of mutual recognition (p < 0.005).Conclusions: These findings suggested that a premature birth and the child's hospitalization might exert a negative effect on the mothers' emotional state, their perception of parental self-image and, consequently, the early bond with the child—independent from the infants' gestational age at the time of the preterm delivery. The data underlined the importance of involving NICU nurses and clinicians in order to optimize the care for mothers immediately after the preterm birth and during the infant's hospitalization, taking into account psychological needs of mothers of both very preterm and moderately preterm infants.
Highlights
Preterm birth is an important issue in public health and is a major part of worldwide neonatal mortality and morbidity [1]
Mothers of preterm babies often have fewer positive ideas and expectations for their children than mothers of term babies [14, 15]; these could be characterized by a Abbreviations: CLIP, Clinical Interview for Parents of High-Risk Infants; EPDS, Edinburgh Postnatal Depression Scale; Neonatal Intensive Care Units (NICU), Neonatal Intensive Care Unit; STAI, State-Trait Anxiety Inventory
The study had the following specific objectives: a) To verify whether Group A and Group B differ with regards to the possible presence of anxiety and depressive symptoms in mothers; b) To verify whether Group A and Group B differ with regards to the mothers’ representations about the delivery and their relationship with the premature child; c) To verify whether the mothers’ anxiety and depressive symptoms predict the quality of their representations of the child and of themselves as parents, considering gestational age
Summary
Preterm birth is an important issue in public health and is a major part of worldwide neonatal mortality and morbidity [1]. As frequently reported in the literature, the first moments of postpartum period are fundamental for the construction of early parent-infant bonding [9, 10] During hospitalization of their baby, mothers may experience several and often contradictory emotional reactions, such as grief, sadness, guilt, fear, anger, loss of self-esteem, and sense of failure [11]. This situation can be so overwhelming for mothers that they might react by emotionally distancing themselves from their children [12, 13]. Mothers of preterm babies often have fewer positive ideas and expectations for their children than mothers of term babies [14, 15]; these could be characterized by a Abbreviations: CLIP, Clinical Interview for Parents of High-Risk Infants; EPDS, Edinburgh Postnatal Depression Scale; NICU, Neonatal Intensive Care Unit; STAI, State-Trait Anxiety Inventory
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