Stress and depression among parents of neonatal intensive care unit patients: assessment using behavioral health and social provisions scales and salivary stress biomarkers

This submission has open access
Submission ID :
ESPR436
Submission Type
Submission Topic
Abstract: :

Background: Parents of newborns admitted to a neonatal ICU (NICU) experience psychosocial stress, depression, and anxiety more frequently than do parents of healthy infants. Aside from infants' clinical condition, extrinsic stressors (travel distance, stressful home situations, pre-existing psychosocial factors) can contribute to NICU parents' stress. 

Objective: We integrate serial behavioral health and economic assessments with demographic factors and salivary stress biomarker measurements to determine risk profiles among NICU parents. The primary objective is to establish: (a) risk factors contributing to psychosocial stress in NICU parents and (b) the association of depression/perceived stress with salivary stress biomarkers. 

Methods: NICU parents of infants born ≤34 wks gestational age (GA) or of term/near term infants who have predicted extended stay (2+ wks) are eligible. Salivary cortisol (AM, PM) and α-amylase are obtained during the 1st hospital wk, at 6 wks, and near discharge. At these times, parental subjects complete the Edinburgh Postpartum Depression Scale (EPDS), Perceived Stress Scale (PSS), and Social Provisions Scale (SPS). We record infant data (e.g., GA, birth weight [BW], length of stay, diagnoses, procedures) as well as the Score for Neonatal Acute Physiology Perinatal Extension-II (SNAPPE-II) and Neonatal Therapeutic Intervention Scoring System (NTISS) (both scored at times of survey and salivary collections).

Results: To date, results are available from 17 parents of 12 infants (10 mothers, 7 fathers) (projected study total=100). Median parental age is 32 yrs, range 16-46 yrs. Parents self-identified as white (53%), Asian (23.5%), and African-American (23.5%); 11.8% are Hispanic. This was a first child for seven sets of parents (58.3%). Four sets of parents (33.3%) reported a history of miscarriage(s). Two subjects reported a history of depression (11.7%); none had previous neonatal loss, infertility, past postpartum depression, substance abuse, or anxiety disorder. The distance from home to NICU was 25 miles (median), range 5-60 miles. Preliminary results include higher self-reported stress levels in fathers compared to mothers. However, we found no clear relationship between infant illness severity and parental stress. On the initial EPDS, nearly 18% of parents scored sufficiently high (>13) to warrant referral for additional support/counseling services via the NICU clinical social worker and psychologist. Salivary samples are currently being analyzed. 

Conclusions: Psychosocial stress and depression are common among parents of NICU infants. Lower GA and BW of infants but not infant's illness severity (SNAPPE-II or NTISS scores) were associated with higher parental stress/depression scoring. As a group, fathers expressed greater stress/depression than mothers. Coupled with pending salivary assays of stress, these findings will further characterize the sources of NICU parental stress and suggest systematic interventions.

MedStar Georgetown University Hospital
Georgetown University Hospital
Georgetown University Hospital
Georgetown University Medical Center

Similar Abstracts by Type

Submission ID
Submission Title
Submission Topic
Submission Type
Corresponding Author
ESPR157
Clinical Research
Original science
Aditya Chhikara
ESPR302
Epidemiology
Original science
Natasha Jouk
ESPR74
Clinical Research
Original science
Alexandra Mazo
26 hits