Maternal post-traumatic stress and depression symptoms and outcomes after NICU discharge in a low-income sample: a cross-sectional study

BMC Pregnancy Childbirth. 2021 Jan 12;21(1):48. doi: 10.1186/s12884-020-03536-0.

Abstract

Background: 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. 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/ methods: In 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.

Results: One 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.

Conclusions: More 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.

Keywords: Low-income; NICU; Post partum depression; Post-traumatic stress.

MeSH terms

  • Adult
  • California
  • Cross-Sectional Studies
  • Depression, Postpartum / ethnology
  • Depression, Postpartum / psychology
  • Ethnicity
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Male
  • Mothers / psychology*
  • Patient Discharge*
  • Poverty
  • Pregnancy
  • Prenatal Care*
  • Psychometrics
  • Puerperal Disorders / ethnology
  • Puerperal Disorders / psychology*
  • Stress Disorders, Post-Traumatic / ethnology
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires