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Published on: January 7, 2020
Risk factors and preventive strategies for post-traumatic stress disorder in neonatal intensive care unit
Maria Di Chiara1, Gianluigi Laccetta1, Sara Gangi1
1Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Insights
Neonatal intensive care unit (NICU) admission increases parental post-traumatic stress disorder (PTSD) risk, especially for preterm infants. Early Kangaroo Care (KC) significantly reduces PTSD occurrence in parents.
Area of Science:
- Perinatology and Neonatology
- Psychiatry and Mental Health
- Parental Well-being
Background:
- Preterm birth and neonatal intensive care unit (NICU) admission are significant stressors for parents.
- Parental post-traumatic stress disorder (PTSD) following NICU admission is linked to adverse effects on parental mental health and caregiving quality.
- Understanding risk factors and preventive measures for parental PTSD in the NICU setting is crucial.
Purpose of the Study:
- To investigate key risk factors for parental PTSD in newborns admitted to the NICU.
- To identify preventive strategies for managing PTSD in parents of NICU-admitted neonates.
- To assess the impact of early life factors on parental mental health outcomes post-NICU.
Main Methods:
- Study included parents of preterm infants consecutively admitted to a NICU.
- PTSD was assessed using the Clinician-administered PTSD scale (CAPS) at enrollment and post-discharge.
- Evaluated parental stress, anxiety (State-Trait Anxiety Inventory), depressive symptoms (Beck Depression Inventory), and family environment.
Main Results:
- Lower gestational age of newborns significantly influenced the occurrence of PTSD in parents.
- Parents of infants in the NICU exhibited higher scores on the Parental Stressor Scale compared to controls.
- Early implementation of Kangaroo Care (KC) was found to significantly reduce the incidence of PTSD.
Conclusions:
- Parental PTSD following preterm birth and NICU admission requires timely management.
- The NICU environment is a primary risk factor contributing to parental PTSD.
- Kangaroo Care (KC) demonstrates a significant protective effect against the development of parental PTSD.
Background:
Preterm birth and admission to the neonatal intensive care unit (NICU) could induce post-traumatic stress disorder (PTSD). PTSD is an important factor to focus on, as it is associated with parental mental health difficulties and with changes in caregiving quality such as increased intrusiveness, reduced sensitivity, and increased attachment insecurity for the child.
Aims:
We aimed to study the main risk factors, in the early life of newborns, and preventive measures for PTSD in parents of neonates hospitalized in the NICU.
Methods:
We included parents of preterm newborns, consecutively admitted to the NICU of the University La Sapienza of Rome. The presence of PTSD following preterm birth and NICU admission was assessed using the Clinician-administered PTSD scale (CAPS) at enrollment and at 28-30 days following NICU admission or the moment of discharge. We also evaluated the Family Environment Scale which measures the social environment of all types of families; the Parental Stressor Scale which measures parental anxiety and stress; the Spielberger State-Trait Anxiety Inventory consisting of two parts measuring the State (response to present situation) and Trait (pre-disposition to be anxious) anxieties separately, and the Beck Depression Inventory Second Edition assessing depressive symptoms.
Results:
We found, in a multivariate analysis, that the gestational age of newborns admitted to NICU significantly (β = 2.678; p = 0.040) influences the occurrence of PTSD. We found that the cases showed significantly (β = 2.443; p = 0.020) more pathological Parental Stressor Scale sights and sounds scores compared to controls. The early Kangaroo-Care (KC) significantly (β = -2.619; p = 0.015) reduces the occurrence of PTSD.
Conclusion:
Post-traumatic stress disorder in parents of preterm newborns is a pathological condition that should be properly managed, in the very first days after birth. The NICU environment represents a main risk factor for PTSD, whereas KC has been demonstrated to have a protective role in the occurrence of PTSD.
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