Impact of Neonatal Intensive Care Units Experience on Child and Parent: A Developing Country Perspective

To examine the associations of maternal psychological distress and neonatal medical risk during Neonatal Intensive Care Unit (NICU) hospitalization with child developmental outcomes, parental burnout, and perceived family impact at 18 to 24 months corrected age in a middle-income country setting with limited perinatal mental health infrastructure.

This prospective, observational study included 175 mother-infant dyads admitted to a tertiary NICU transitional unit. Maternal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Perinatal Anxiety Screening Scale-Turkish Version (PASS-TR), respectively. Neonatal medical complexity was quantified using a composite Neonatal Risk Score (NRS). At 18 to 24 months corrected age, 112 infants and 96 mothers completed follow-up assessments including the Ages and Stages Questionnaire (ASQ-3), the Parental Burnout Assessment, and the Impact on Family Scale.

Maternal depressive (39.9%) and anxiety (75.8%) symptoms were common during the NICU stay but not linked to sociodemographic factors. Higher EPDS and PASS-TR scores were associated with developmental delays in communication, problem-solving, and personal-social domains. Parental burnout correlated with maternal depression, poorer child communication and motor outcomes, and higher NRS. Mothers of infants with hydrocephalus reported the highest distress and burnout.

Maternal mental health and neonatal medical risk during NICU hospitalization were important correlates of later child and family outcomes. Routine psychosocial screening and risk stratification in NICU settings may facilitate early identification of at-risk dyads. In low-resource settings, integrated perinatal mental health support may be essential to improving long-term developmental and psychosocial outcomes.