Maternal depression, anxiety, stress, and maternal-infant attachment in the neonatal intensive care unit

J Reprod Infant Psychol. 2020 Jul;38(3):297-310. doi: 10.1080/02646838.2019.1695041. Epub 2019 Dec 4.

Abstract

Objective: The objectives of this study were to identify maternal psychological responses to infants' neonatal intensive care unit (NICU) admission, understand the relationship between psychological symptoms and maternal-infant attachment, and evaluate change in psychological symptoms over time.

Background: Accumulating evidence suggests that infants' admission to a NICU may adversely impact maternal psychiatric functioning. NICU mothers typically experience high levels of depressive, anxiety, and stress symptoms.

Methods: Mothers (N = 127) recruited from their infants' NICU bedside at three hospitals in the Philadelphia area completed self-report measures of depression, anxiety, stress, and maternal-infant attachment during the NICU admission and then 2-4 months later. A series of bivariate correlations, paired samples t-tests, and linear regression analyses were used to evaluate the primary study aims.

Results: NICU mothers reported elevated rates of depressive, anxiety, and stress symptoms. Maternal-infant attachment was negatively associated with anxiety and stress symptoms. Both depressive and anxiety symptoms were higher during NICU admission compared to 2-4 months later, and depressive symptoms during NICU admission predicted depressive symptoms 2-4 months later.

Conclusions: This study demonstrates that NICU admission may heighten maternal risk for psychiatric symptoms, and maternal-infant attachment in the NICU may be an important correlate of maternal anxiety and stress symptoms.

Keywords: Neonatal intensive care unit; maternal-infant attachment; postpartum anxiety; postpartum depression.

MeSH terms

  • Adult
  • Anxiety / psychology*
  • Depression, Postpartum / psychology*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Longitudinal Studies
  • Mother-Child Relations*
  • Mothers / psychology*
  • Philadelphia
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires