Screening for Posttraumatic Stress Disorder in Mothers of Premature Infants: An Evidence-Based Approach

The purpose of this article is to outline a quality-improvement initiative designed to improve screening for post-traumatic stress disorder (PTSD) among parents with preterm infants born less than 30 weeks of gestation into the neonatal ICU (NICU).

Parents of infants admitted to the NICU face significant trauma, leading to elevated risks of postpartum PTSD. Left undetected, PTSD can results in impaired maternal-infant bonding, parental functioning, and long-term child cognitive and emotional development. Despite available guidelines, routine assessment specifically for PTSD in the NICU environment remains uncommon.

A screening bundle was initiated consisting of staff education on the use of the City Birth Trauma Scale, planned parent PTSD assessments, and a designated staff nurse champion. Among 16 analyzed responses (13 mothers, 3 significant others), 25% met all diagnostic criteria for high likelihood of PTSD, with 75% of those exhibiting dissociative symptoms. Additionally, negative cognitions/mood (68.8%) and hyperarousal (56.3%) were highly prevalent, and 50% reported significant life impairment.

Implementing a screening process is a practical and parent focused method to uncover substantial, previously unrecognized PTSD symptoms among NICU parents. Clinical practice locations have an opportunity to create an inclusive environment for the assessment and discussion of PTSD and the impacts on the family and infant. Future research should explore larger multi-site studies, tracking non-response rates, and evaluating screening at multiple intervals to capture delayed-onset PTSD.