Social, emotional factors may raise risk of postpartum depression in mothers of preterm infants

Postpartum depression is the most common complication of pregnancy and childbirth, affecting up to 15 percent of all women within the first three months following delivery. Research has shown that mothers of infants born prematurely have almost double the rates of postpartum depression, particularly during their time in the neonatal intensive care unit (NICU).

Research led by Betty R. Vohr, MD, director of Women & Infants' Neonatal Follow-Up Program and professor of pediatrics at The Warren Alpert Medical School of Brown University, found that there are certain social and emotional factors that further increase the risk of postpartum depression in mothers of preterm infants. The research, entitled "Social Emotional Factors Increase Risk of Postpartum Depression in Mothers of Preterm Infants," has been published in The Journal of Pediatrics. Lead author is Katheleen Hawes, PhD, RN, of the Center for Children and Families at Women & Infants Hospital of Rhode Island and assistant professor (adjunct) in the Department of Pediatrics at the Alpert Medical School.

"We found mothers with a previous mental health disorder and experiencing negative perceptions of herself and her infant at NICU discharge were at increased risk for depression one month post discharge, regardless of the infant's gestational age at birth," explained Hawes.

The study included 724 mothers of preterm infants who were cared for more than five days in the NICU and participated in a Transition Home Program. Families in the program received enhanced support and education about their infants from former NICU parents trained as family resource specialists. Participants completed an evaluation prior to discharge to determine their perceptions of NICU staff support, infant well-being, maternal well-being (emotional readiness/competency), and maternal comfort (worry about her infant). Mental health history and social risk factors were also obtained by the researchers. At one month post discharge, the Edinburgh Postnatal Depression Scale was administered.

Hawes said, "Mothers of early, moderate and late preterm infants reported similar rates of possible depression - 20%, 22% and 18% respectively - one month after NICU discharge. A history of mental health disorder, decreased perception of maternal well-being, decreased maternal comfort regarding her infant, and decreased perception of family cohesion were also associated with possible depression at one month post discharge."

Hawes and her colleagues concluded that comprehensive mental health assessment prior to discharge is essential to identify women at risk and provide appropriate referrals. She said, "Comprehensive transition home assessment and interventions to reduce anxiety and bolster maternal mental health, confidence and readiness, along with post discharge assessment, are needed to identify, treat and support mothers of preterm infants."


Care New England


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