Maternal Depression and Stress in the Neonatal Intensive Care Unit: Associations With Mother-Child Interactions at Age 5 Years

Abstract

Objective: Previous studies suggest that maternal postpartum mental health issues may have an impact on parenting and child development in preterm infants, but have often not measured symptomatology in the neonatal intensive care unit (NICU) or followed families through early childhood. This study examines how maternal depressive symptoms and stress in the NICU are related to parenting behaviors at age 5 years, in mothers of children born very preterm (at ≤30 weeks' gestation).

Method: This longitudinal study followed a diverse sample of 74 very preterm children and their mothers. Maternal depression and stress were assessed in the NICU. At age 5, mother-child dyads were observed and coded for maternal intrusiveness, negativity, sensitivity, and positivity. Other covariates, including maternal and child intelligence, maternal education, income-to-needs ratio, maternal depression at age 5 years, and child sex were included in multivariate analyses.

Results: The interaction between maternal NICU stress and NICU depression for intrusiveness and negativity indicates that greater NICU depression was associated with more intrusiveness under medium or high levels of NICU stress, and more negativity under high levels of NICU stress. Furthermore, greater NICU depression was associated with less sensitivity, over and above other covariates.

Conclusion: Findings suggest that early maternal peripartum depression and stress in the NICU can have lasting impacts on multiple parenting behaviors, highlighting the need for screening and targeted interventions in the NICU.

Keywords: NICU; depression; parent-child interactions; parenting; preterm.