Risk Factors for Postpartum Depression and Severe Distress among Mothers of Very Preterm Infants at NICU Discharge-Reference-Cited by-同舟云学术

Risk Factors for Postpartum Depression and Severe Distress among Mothers of Very Preterm Infants at NICU Discharge

Published:2023-04-18 Issue: Volume: Page:
ISSN:0735-1631
Container-title:American Journal of Perinatology
language:en
Short-container-title:Am J Perinatol

Author:

Hofheimer Julie A.¹^ORCID,McGowan Elisabeth C.²,Smith Lynne M.³,Meltzer-Brody Samantha⁴,Carter Brian S.⁵,Dansereau Lynne M.⁶,Pastyrnak Steven⁷,Helderman Jennifer B.⁸,Neal Charles R.⁹,DellaGrotta Sheri A.⁶,O'Shea Thomas Michael D.¹,Lester Barry M.¹⁰¹¹

Affiliation:

1. Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

2. Department of Pediatrics, Women and Infant's Hospital/Brown University, Providence, Rhode Island

3. Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles, California

4. Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

5. Department of Pediatrics, Department of Medical Humanities and Bioethics, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri

6. Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, Rhode Island

7. Department of Pediatrics, Spectrum Health Helen DeVos Children's Hospital/Michigan State University, Grand Rapids, Michigan

8. Department of Pediatrics, Wake Forest University School of Medicine, Winston Salem, North Carolina

9. Division of Neonatology, Department of Pediatrics, Kapi'olani Medical Center for Women and Children and Hawaii Pacific Medical Group, University of Hawaii John A Burns School of Medicine, Honolulu, Hawaii

10. Departments of Pediatrics, Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, Rhode Island

11. Department of Psychiatry and Human Behavior, Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, Rhode Island

Abstract

Objective To identify psychological, medical, and socioenvironmental risk factors for maternal postpartum depression (PPD) and severe psychological distress (SPD) at intensive care nursery discharge among mothers of very preterm infants. Study Design We studied 562 self-identified mothers of 641 infants born <30 weeks who were enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants Study (NOVI) conducted in nine university-affiliated intensive care nurseries. Enrollment interviews collected socioenvironmental data, depression, and anxiety diagnoses prior to and during the study pregnancy. Standardized medical record reviews ascertained prenatal substance use, maternal and neonatal medical complications. The Edinburgh Postnatal Depression Scale and Brief Symptom Inventory were administered at nursery discharge to screen for PPD and SPD symptoms, respectively. Results Unadjusted analyses indicated mothers with positive screens for depression (n = 76, 13.5%) or severe distress (n = 102, 18.1%) had more prevalent prepregnancy/prenatal depression/anxiety, and their infants were born at younger gestational ages, with more prevalent bronchopulmonary dysplasia, and discharge after 40 weeks postmenstrual age. In multivariable analyses, prior depression or anxiety was associated with positive screens for PPD (risk ratio [RR]: 1.6, 95% confidence interval [CI]: 1.1–2.2) and severe distress (RR: 1.6, 95% CI: 1.1–2.2). Mothers of male infants had more prevalent depression risk (RR: 1.7, 95% CI: 1.1–2.4), and prenatal marijuana use was associated with severe distress risk (RR: 1.9, 95% CI: 1.1–2.9). Socioenvironmental and obstetric adversities were not significant after accounting for prior depression/anxiety, marijuana use, and infant medical complications. Conclusion Among mothers of very preterm newborns, these multicenter findings extend others' previous work by identifying additional indicators of risk for PPD and SPD associated with a history of depression, anxiety, prenatal marijuana use, and severe neonatal illness. Findings could inform designs for continuous screening and targeted interventions for PPD and distress risk indicators from the preconception period onward. Key Points

Funder

National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health

Link

http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0043-1768132.pdf

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