The level and sources of stress in mothers of infants admitted in neonatal intensive care unit

Abstract

Background: Hospitalization of a new-born child is stressful for parents. This study was done to determine the level and sources of stress in mothers of infants admitted in Neonatal Intensive Care Unit (NICU) and variance in stress by infant and maternal characteristics. Materials and Methods: Parental Stressor Scale for NICU was used as the primary outcome measure. Maternal socio-demography, maternal and infant characteristics such as gravidity, number of prenatal visits, perceived support from family members, perceived level of discomfort that the baby underwent, pregnancy and delivery complications, gestational age, sex, birth weight, length of NICU stay and ventilator support, and neonatal morbidity were also collected from maternal and infant hospital records. Results: Amongst these rural and poorly educated mothers, the appearance of the baby, sights and sounds of NICU environment were major sources of stress. Higher maternal stress was found to be associated with poor family support during pregnancy, mothers' perception of the baby's discomfort, lower birth weight of the baby, baby on ventilator, post-partum depression, and moderate to severe anxiety symptoms. Mothers who had higher levels of education and those with pregnancy complications were more stressed. Conclusions: Before designing remediation programs for parents, local demography and the predominant NICU stressors need to be kept in mind. Possibility of screening at-risk mothers by questioning them about perception of baby's discomfort needs to be evaluated further.

Keywords

• Maternal stress
• Neonatal Intensive Care Unit environment
• parental role alteration
• PSS-NICU Key messages: Looks and behavior of the baby followed by parental role alternation were major sources of maternal stress. Higher stress was seen amongst mothers of Very Low Birth Weight infants and those needing ventilation. Lower education level may mitigate maternal stress.