Parent Mental Health From Preterm Birth Through the NICU Stay

Abstract

OBJECTIVES: Preterm birth and neonatal intensive care unit (NICU) admission are not only extremely stressful for the infant itself but can also impact parental mental health. This Dutch national prospective cohort study aimed to describe the trajectory of parental mental health following preterm birth (<29 weeks of gestation) and identify contributing factors for mothers and fathers separately. METHODS: As part of the "Happiness for the Improvement of Premature and Parental Outcome" study, parents completed questionnaires on posttraumatic stress and depressive symptoms at 3 time points up to term-equivalent age. To determine potential contributing factors, additional questionnaires were completed to capture prenatal psychosocial history, family and birth-related factors, postnatal stressors, and protective factors. Data were analyzed using unstructured mixed-effects models and generalized least squares. RESULTS: Questionnaires were completed by 217 of 385 families (of 259/446 children). Clinically elevated posttraumatic stress symptoms peaked at term-equivalent age, affecting 35.1% of mothers and 16.4% of fathers. Clinically elevated depressive symptoms peaked at 1 to 2 weeks after birth in mothers (39.5%) and at term-equivalent age in fathers (24.3%). For both parents, prenatal psychosocial history and NICU-related parental stress were significant contributors to parental mental health. More neonatal stress exposure, having fewer children, and perceived social support were additional factors for fathers' mental health only. CONCLUSIONS: These findings illustrate the impact of preterm birth and NICU admission on parental mental health. Identification of shared and parent-specific risk factors is important to identify parents with the highest risk for adverse outcomes and provides opportunities for early interventions.