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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Measurement of Cumulative Preterm Neonatal and Maternal Stressors During Neonatal Intensive Care Unit Admission
Reham I Abdelmageed1, Azza M Youssef1, Rania A El-Farrash1
1Pediatrics Department, Faculty of Medicine, Ain Shams University, Egypt.
Insights
The neonatal intensive care unit (NICU) environment causes significant stress for premature infants and their mothers. Higher cumulative infant stress in the NICU is linked to increased maternal psychological distress.
Area of Science:
- Neonatal care
- Maternal mental health
- Pediatric stress research
Background:
- The neonatal intensive care unit (NICU) presents a high-stress environment for vulnerable preterm infants and their families.
- Understanding the impact of early life stressors on infant well-being and maternal mental health is crucial for optimizing NICU care.
Purpose of the Study:
- To quantify the severity of early life stressors experienced by preterm infants in the NICU.
- To evaluate the association between cumulative neonatal stressors and maternal mental health outcomes.
Main Methods:
- A cross-sectional study involving 100 preterm infants and their mothers in the NICU.
- Infant stressors were measured daily for 10 days using the Neonatal Infant Stressor Scale.
- Maternal psychological well-being was assessed using the Parental Stressor Scale: NICU and Edinburgh Postnatal Depression Scale.
Main Results:
- Preterm infants underwent an average of 350.76 acute procedures and 44.84 hours of chronic stress during their first 10 NICU days.
- Blood gas sampling was the most painful acute procedure, while intravenous flushing was most frequent.
- 45% of mothers exhibited depressive symptoms, with maternal role alteration being a significant stressor, particularly for younger mothers. Infant cumulative stressors correlated with maternal psychological maladjustment.
Conclusions:
- The NICU environment imposes substantial acute and chronic stressors on preterm infants.
- Cumulative neonatal stressors significantly negatively impact maternal mental health, highlighting the interconnectedness of infant and maternal well-being in the NICU.
Objectives:
By nature, the neonatal intensive care unit (NICU) environment is stressful for both infants and mothers. This study aimed to explore and quantify the severity of early life stressors in premature infants admitted to the NICU and evaluate the effect of cumulative neonatal stressors on maternal mental health.
Methods:
This cross-sectional study included 100 preterm infants admitted to the NICU for at least 10 days. Daily experiences with painful/stressful procedures for 10 days were determined using the Neonatal Infant Stressor Scale. The included mothers were assessed for their psychological well-being 1 week after NICU admission using the Parental Stressor Scale: NICU and Edinburgh Postnatal Depression Scale.
Results:
During the first 10 days of NICU admission, preterm infants experienced an average of 350.76 ± 84.43 acute procedures and an average of 44.84 ± 11.12 cumulative hours of chronic events, with the highest scores recorded on first 3 days of admission. Although intravenous flushing for patency was the most frequent acute procedure, blood gas sampling was the most painful. Forty-five percent of the mothers showed significant depressive symptoms, with the maternal role alteration reported as the most stressful experience, especially for young and new mothers (p < .001). The cumulative stressors experienced by infants were significantly associated with elevated maternal perception of psychological maladjustment (p < .001).
Conclusion:
This study confirmed that the NICU environment is stressful for both infants and mothers, with the total cumulative stressors experienced by preemies in the NICU having an negative impact on maternal mental health.
