Maternal psychiatric functioning and maternal-infant attachment among mothers of infants in the neonatal intensive care unit (NICU)

Philadelphia, PA

Introduction: A growing body of research suggests that an infant’s admission to a neonatal intensive care unit (NICU) may adversely impact maternal psychiatric functioning, affecting quality of life, well-being, and patient outcomes. Additionally, there is accumulating evidence that stressful reproductive events related to a NICU admission) may even exacerbate pre-existing maternal psychiatric symptoms. The purpose of the current study was to examine the relationships between maternal mental health symptoms, including anxiety and stress, and maternal-infant attachment among mothers of infants in the NICU. By examining the psychiatric functioning measures both at the time of initial NICU admission and again 2-4 months later for a follow up assessment, we were able to evaluate the change in maternal stress and anxiety over time and the relationship with maternal-infant attachment while in the NICU.

Methods: One hundred twenty-seven mothers were recruited from their infants’ NICU bedside at three hospitals in the Philadelphia area and completed self-report measures of anxiety, stress, and maternal-infant attachment during the NICU admission and then measures of anxiety and stress again 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 self-reported elevated rates of anxiety and stress symptoms. Furthermore, maternal-infant attachment was negatively associated with anxiety and stress symptoms. Anxiety symptoms were higher during initial NICU admission compared to 2-4 months later, while there was no significant difference in stress symptoms at initial assessment or follow up assessment.

Discussion: The current study evaluated the relationship among maternal psychiatric symptoms (i.e. anxiety and stress) and maternal-infant attachment in mothers at their infant’s initial NICU admission and assessed this change over time. The results of this study suggest that more research can be done to explore the different sources of stress and anxiety symptoms at time of initial NICU admission and later when the majority of mothers have brought their infant home. For example, this study demonstrated that stress remains high both during NICU hospitalization and post-discharge; perhaps mothers were initially experiencing stress about their infant’s health while in the NICU, and later were stressed about adequately fulfilling increased responsibility with intensive care for their infant at home without the support of NICU staff). An increased understanding of the source of stress is important to help inform possible screening protocols and interventions to address mothers’ psychiatric symptoms while their infant is still in the NICU to better prepare them for the transition of bringing their infant home.