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

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.