Thirteen years ago, Susanne Klawetter gave birth to triplets. They required a stay in a neonatal intensive care unit (NICU). Stays like Klawetter's are relatively common: about 10 percent of all babies born nationwide will require care in a NICU, according to the National Institutes of Health.
The experience is traumatic and can have negative, lasting impacts for both the baby and parents. But health systems don't have an infrastructure in place to support NICU parents in a systematic way.
"The NICU experience can be really tough. We need to be thinking about how we can support families navigating it," Klawetter said.
Her experience inspired the Portland State University Assistant Professor of Social Work to seek change and research the needs of NICU parents.
Klawetter received a two-year, $740,601 grant through the NW Patient-Centered Learning Health Systems Science K12 Research Career Development Program to support her research project. She's the first recipient of a K-12 grant in the PSU School of Social Work.
The grant will allow Klawetter to identify the behavioral health needs of parents with NICU babies -- which could include features like on-site counseling or access to peer support -- and identifying barriers to meeting those needs. She will partner with Oregon Health & Science University to conduct the study.
Once she determines what health systems could offer to better support parents, Klawetter will pull together a workgroup to figure out what a sustainable program might look like.
"There's such a tremendous opportunity for health systems to really impact the long-term trajectory of the family in a focused way," Klawetter said.
Parents with babies in the NICU also have a higher risk of depression, anxiety, post-traumatic stress disorder (PTSD) and substance abuse, according to NIH statistics. The postpartum depression rate in the U.S., for example, is 10 to 15 percent for the general maternal population. That rate jumps to 39 to 55 percent for mothers with babies in the NICU.
Research also shows that mothers with infants in the NICU have a higher prevalence of severe anxiety -- 43 percent -- and parents hold onto the stress and trauma of their experience in the NICU for more than a month after discharge in the form of PTSD, according to NIH. That's the case for 15 percent of mothers and 8 percent of fathers.
"My position is that if we can figure out how to have the health system provide behavioral health support for families in the NICU, you will ultimately improve patient outcomes," Klawetter said.
The good news is providers want to support families in the NICU but the best way to do this is currently a knowledge gap.
"I think they care about families and want to increase knowledge about how to support NICU families," she added.
Klawetter's research will begin in earnest this summer with the hiring of a PSU graduate assistant. After completing phase one of her project, Klawetter plans to apply for a new grant to design a pilot project based on her findings.