Postpartum Depression in Mothers of Newborns Hospitalized in a Neonatal Intensive Care Unit

Background: Literature examining psychological maladjustment in mothers of infants admitted to the Neonatal Intensive Care Unit (NICU) reports that these mothers have consistently higher rates of postpartum depression (PPD), compared with mothers of healthy term infants outside of the NICU.

Objective: To explore the postpartum depression in mothers of infants admitted to a NICU.

Methods: A literature review was conducted in Medline and Scopus database regarding postpartum depression.

Results: Mothers of infants admitted to a NICU experience heightened distress, significant symptoms of depression and anxiety disorders because they are rarely prepared for the shock, stress and anxiety when their infant is sick enough to require critical care in a NICU. Mothers with PPD were significantly more anxious, hostile, and depressed, and they were more poorly adjusted than fathers in studies examining PPD in mother–father pairs of high-risk infants. Longer length of stay at the NICU, increased time of infant on life support and more serious clinical problems are significantly correlated with elevated depressive symptoms. Parental role alteration and the prolonged ventilation of the infant were related to the increased depressive symptoms reported by the mothers of the NICU infants. Mothers with higher levels of social support show greater decreases in depressive symptoms over time. Perception of nurse support have a significant inverse relationship with depressive symptoms, reiterating that nurses are a vital resource for mothers of NICU infants.

Conclusion: Mothers could benefit from nurses who have been educated about the complex nature of maternal stress and depressive symptoms in the NICU, as the nurses would then be able to more appropriately identify mothers at higher risk for developing PPD. As screening programs are implemented, systems for appropriate referrals for further assessment, intervention, and clinical services are critical.