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Updated: Oct 26, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Maternal and Paternal Depression Symptoms During NICU Stay and Transition Home
Craig F Garfield1,2, Young S Lee2, Liam Warner-Shifflett2
1Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois c-garfield@northwestern.edu.
Insights
Maternal depression symptoms decrease during NICU stays but may rise post-discharge, while paternal symptoms show a different trajectory. Early screening in the NICU improves postpartum depression risk prediction.
Area of Science:
- Neonatal Intensive Care Unit (NICU) care
- Parental mental health
- Perinatal psychiatry
Background:
- Parental depression is a significant concern for infants in the NICU.
- Understanding the evolving nature of parental depression symptoms is crucial for timely intervention.
- Existing research often focuses on mothers, potentially overlooking paternal mental health in the NICU context.
Purpose of the Study:
- To investigate the changes in depression symptoms among parents of premature infants from NICU admission through 30 days post-discharge.
- To identify risk factors associated with parental depression during this critical period.
- To compare the depressive symptom trajectories between mothers and fathers.
Main Methods:
- A prospective longitudinal cohort study involving parents of premature infants admitted to the NICU.
- Utilized the Edinburgh Postnatal Depression Scale (EPDS) for screening at four time points: NICU admission, discharge, and 14 and 30 days post-discharge.
- Employed mixed-effects regression models to analyze EPDS score changes and the probability of positive screening (EPDS ≥10).
Main Results:
- A significant proportion of parents screened positive for depression: 33% of mothers and 17% of fathers.
- Mothers showed a greater decrease in depressive symptoms during the NICU stay compared to fathers.
- Early screening during NICU admission or at discharge significantly improved the prediction of 30-day depressive symptoms.
Conclusions:
- Mothers and fathers exhibit distinct patterns of depressive symptom changes from NICU hospitalization to home.
- Screening parents for postpartum depression during the NICU stay enhances the identification of those at risk after discharge.
- There is a need for focused attention on the mental health of fathers in the NICU setting.
Objective:
To examine the trajectory and risk factors of depression symptoms among parents from NICU admission to 30 days postdischarge. We hypothesized depression symptom scores would decrease from admission and then increase from discharge to 30 days.
Methods:
Prospective longitudinal cohort study of premature infants in NICU. Parents completed the validated Edinburgh Postnatal Depression Scale (EPDS) at 4 time points: NICU admission, discharge, and 14 days and 30 days postdischarge. EPDS score change across time and probability of a positive screen (EPDS ≥10) were by assessed using mixed effect regression models.
Results:
Of 431 parents enrolled (mothers, n = 230 [53%]), 33% of mothers (n = 57) and 17% of fathers (n = 21) had a positive EPDS screening. Score change was 1.9 points different between mothers and fathers (confidence interval [CI]: 1.3-2.6; P < .0001), with mothers decreasing 2.9 points (CI: 2.1-3.7; P < .0001) and fathers decreasing 1.0 points (CI: 0.1-2.0; P = .04). Over time, mothers decreased 10.96 times (CI: 2.99-38.20; P = .0003); fathers decreased at a nonsignificant rate. Admission or discharge screening improved 30-day depressive symptom prediction (AUC 0.66 baseline demographics only versus 0.84+initial [P < .0001], and versus 0.80+discharge screening [P < .001]).
Conclusions:
Mothers and fathers experience different depressive symptom trajectories from NICU to home. Screening parents for postpartum depression during the NICU stay is likely to result in improved identification of parents at risk for postpartum depression after discharge. Focused attention on fathers appears warranted.
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