Social Emotional Factors Increase Risk of Postpartum Depression in Mothers of Preterm Infants

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• 作者：Katheleen Hawes ; PhD ; RN¹ ; ² ; ³ ; ^{khawes@wihri.org" class="auth_mail" title="E-mail the corresponding author} ; Elisabeth McGowan ; MD¹ ; ² ; Melissa O'Donnell ; MSW¹ ; Richard Tucker ; BA¹ ; ² ; Betty Vohr ; MD¹ ; ²
• 关键词：depression ; NICU ; prematurity ; maternal perceptions ; social risk factor
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：179
• 期：Complete
• 页码：61-67
• 全文大小：205 K

文摘

To examine the association of maternal mental health, perceptions of readiness at neonatal intensive care unit (NICU) discharge, and social risk factors with depressive symptoms 1 month postdischarge in mothers of early (<32 weeks), moderate (32-33 weeks), and late (34-36 weeks) preterm infants. A secondary objective was to compare depressive symptoms among mothers in all preterm groups.

Study design

Mothers (n = 734) of preterm infants cared for >5 days in the NICU and participating in a Transition Home Program completed the Fragile Infant Parent Readiness Evaluation prior to discharge for perceptions of NICU staff support, infant well-being, maternal well-being (emotional readiness/competency), and maternal comfort (worry about infant). Mental health history and social risk factors were obtained. At 1 month postdischarge the Edinburgh Postnatal Depression Scale was administered. Group comparisons and logistic regression analyses were run to predict possible depression (Edinburgh Postnatal Depression Scale  ≥10).

Results

Mothers of early, moderate, and late preterm infants reported similar rates of possible depression (20%, 22%, and 18%, respectively) 1 month after NICU discharge. History of mental health disorder, decreased perception of maternal well-being, decreased maternal comfort regarding infant, and decreased perception of family cohesion were associated with possible depression at 1 month postdischarge.

Conclusions

Mothers with a previous mental health disorder and experiencing negative perceptions of self and infant at NICU discharge were at increased risk for depressive symptomatology 1 month postdischarge regardless of infant gestational age. Comprehensive mental health assessment prior to discharge is essential to identify women at risk and provide appropriate referral.