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Updated: Jul 5, 2025

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Parenting Expectations, NICU Experiences, and Maternal Psychological Outcomes: An Exploratory Mixed-Methods Study.

Sarah M Rodrigues1, Sanghyuk S Shin, Melissa D Pinto

  • 1Author Affiliations: Sue & Bill Gross School of Nursing, University of California, Irvine (Drs Rodrigues, Shin, Pinto, and Bounds); Department of Gender & Sexuality Studies, University of California, Irvine (Dr Terry); and School of Nursing, University of Nevada, Las Vegas (Dr Burton).

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|January 12, 2024
PubMed
Summary

Mothers hospitalized with infants in the neonatal intensive care unit (NICU) experience distress when their actual experiences differ from their parenting expectations. Addressing these expectation-experience differences (EEDs) is crucial for maternal mental health post-NICU.

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Area of Science:

  • Perinatal mental health
  • Maternal psychology
  • Neonatal intensive care unit (NICU) outcomes

Background:

  • Infant hospitalization in the NICU significantly elevates maternal psychological distress.
  • Predicting maternal risk is challenging due to a lack of universal screening standards.
  • Examining differences between parenting expectations and NICU experiences can clarify maternal distress.

Purpose of the Study:

  • To explore parenting expectation-experience differences (EEDs) in mothers with infants in the NICU.
  • To assess the correlation between EED scores and maternal psychological outcomes 1-5 years post-NICU hospitalization.

Main Methods:

  • A 3-phase explanatory sequential mixed-methods design was employed.
  • Pearson's correlation coefficients analyzed relationships between EED scores and maternal psychological outcomes.
  • Reflexive thematic analysis of semi-structured interviews provided qualitative context for EED scores.

Main Results:

  • Over 90% of mothers reported negative EEDs, signifying NICU experiences fell short of expectations.
  • Significant inverse correlations were observed between EED scores and depression, anxiety, PTSD symptoms, and parenting self-efficacy.
  • Qualitative themes included unexpectedness, lost parenting experiences, and survival and thriving, highlighting varied meanings of unmet expectations.

Conclusions:

  • Preparing mothers for NICU hospitalization and enhancing NICU parenting support can mitigate EEDs.
  • Interventions aimed at reducing the gap between expectations and experiences may improve maternal mental health.
  • Further research is necessary to fully understand the impact of parenting EEDs in the NICU population.