Abstract
SummaryBackgroundParents of babies admitted to neonatal units (NNU) are exposed to a range of potentially distressing experiences, which can lead to mental health symptoms such as increased anxiety and post-traumatic stress (PTS). This review aimed to describe how anxiety and PTS are defined and assessed, and to estimate anxiety and PTS prevalence among parents of babies admitted to NNU.MethodMedline, Embase, PsychoINFO, Cumulative Index to Nursing and Allied Health literature were searched to identify studies published prior to April 14, 2021. Included studies were assessed using Hoy risk of bias tool. A random-effects model was used to estimate pooled prevalence with 95% CIs. Potential sources of variation were investigated using subgroup analyses and meta-regression. The review is registered with PROSPERO (CRD42020162935).FindingsFifty six studies involving 6,036 parents met the review criteria; 21 studies assessed anxiety, 35 assessed PTS, and 8 assessed both. The pooled prevalence of anxiety was 41.9% (95%CI:30.9, 53.0) and the pooled prevalence of PTS was 39.9% (95%CI:30.8, 48.9) among parents up to one month after the birth. Anxiety prevalence decreased to 26.3% (95%CI:10.1, 42.5) and PTS prevalence to 24.5% (95%CI:17.4, 31.6) between one month and one year after birth. More than one year after birth PTS prevalence remained high 27.1% (95%CI:20.7, 33.6). Data on anxiety at this time point were limited. There was high heterogeneity between studies and some evidence from subgroup and meta-regression analyses that study characteristics contributed to the variation in prevalence estimates.InterpretationThe prevalence of anxiety and PTS was high among parents of babies admitted to NNU. The rates declined over time, although they remained higher than population prevalence estimates for women in the perinatal period. Implementing routine screening would enable early diagnosis and effective intervention.FundingThis research is funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted through the Policy Research Unit in Maternal and Neonatal Health and Care, PR-PRU-1217-21202. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Highlights
A neonatal unit (NNU) provides integrated services for delivering care to sick and preterm babies in need of specialist care
Previous research has shown that mental health problems are common among parents of babies admitted to a NNU.[7−10] Systematic review evidence estimates the prevalence of depression to be as high as 40% in the early postpartum period among women with premature babies[11,12] Less is known about anxiety, as highlighted in a recent scoping review, which found little consistency in prevalence rates across the limited studies reported.[7]
This systematic review and meta-analysis is the first to provide an estimate of the prevalence of anxiety and post-traumatic stress (PTS) among parents of babies admitted to NNU
Summary
A neonatal unit (NNU) provides integrated services for delivering care to sick and preterm babies in need of specialist care. When a baby is admitted to a NNU the experience can be extremely distressing for the parents. Previous research has shown that mental health problems are common among parents of babies admitted to a NNU.[7−10] Systematic review evidence estimates the prevalence of depression to be as high as 40% in the early postpartum period among women with premature babies[11,12] Less is known about anxiety, as highlighted in a recent scoping review, which found little consistency in prevalence rates across the limited studies reported.[7] Research on post-traumatic stress (PTS) has increased in the last decade, yet there is still little known about the prevalence of PTS in this population.[7] There are many challenges for researchers in this field, in particular, the lack of clear, discrete definitions and variability in approaches to measurement of mental health problems in the perinatal period.[13]
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