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      Mothers and Fathers in NICU: The Impact of Preterm Birth on Parental Distress

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          Abstract

          Preterm birth is a stressful event for families. In particular, the unexpectedly early delivery may cause negative feelings in mothers and fathers. The aim of this study was to examine the relationship between preterm birth, parental stress and negative feelings, and the environmental setting of NICU. 21 mothers (age = 36.00 ± 6.85) and 19 fathers (age = 34.92 ± 4.58) of preterm infants (GA = 30.96 ± 2.97) and 20 mothers (age = 40.08 ± 4.76) and 20 fathers (age = 40.32 ± 6.77) of full-term infants (GA = 39.19 ± 1.42) were involved. All parents filled out the Parental Stressor Scale: Neonatal Intensive Care Unit, the Impact of Event Scale Revised, Profile of Mood States, the Multidimensional Scale of Perceived Social Support and the Post-Partum Bonding Questionnaire. Our data showed differences in emotional reactions between preterm and full-term parents. Results also revealed significant differences between mothers and fathers’ responses to preterm birth in terms of stress, negative feelings, and perceptions of social support. A correlation between negative conditions at birth (e.g., birth weight and Neonatal Intensive Care Unit stay) and higher scores in some scales of Impact of Event Scale Revised, Profile of Mood States and Post-Partum Bonding Questionnaire were found. Neonatal Intensive Care Unit may be a stressful place both for mothers and fathers. It might be useful to plan, as soon as possible, interventions to help parents through the experience of the premature birth of their child and to begin an immediately adaptive mode of care.

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          Most cited references53

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          The Multidimensional Scale of Perceived Social Support

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            Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: a systematic review.

            Although much is known about the risk factors for postpartum depression (PPD), the role of giving birth to a preterm or low-birth-weight infant has not been reviewed systematically. To review systematically the prevalence and risk factors for PPD among women with preterm infants. Medline, CINAHL, EMBASE, PsycINFO and the Cochrane Library were searched from their start dates to August 2008 using keywords relevant to depression and prematurity. Peer-reviewed articles were eligible for inclusion if a standardised assessment of depression was administered between delivery and 52 weeks postpartum to mothers of preterm infants. Data on either the prevalence of PPD or mean depression score in the target population and available comparison groups were extracted from the 26 articles included in the review. Risk factors for PPD were also extracted where reported. The rates of PPD were as high as 40% in the early postpartum period among women with premature infants. Sustained depression was associated with earlier gestational age, lower birth weight, ongoing infant illness/disability and perceived lack of social support. The main limitation was that most studies failed to consider depression in pregnancy as a confounding variable. Mothers of preterm infants are at higher risk of depression than mothers of term infants in the immediate postpartum period, with continued risk throughout the first postpartum year for mothers of very-low-birth-weight infants. Targeted clinical interventions to identify and prevent PPD in this vulnerable obstetric population are warranted.
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              The Postpartum Bonding Questionnaire: a validation.

              This is a validation of a self-rating questionnaire designed to detect disorders of the mother-infant relationship. 125 subjects filled in the questionnaire, and were also interviewed using the 5(th) Edition of the Birmingham Interview for Maternal Mental Health. On the basis of these interviews and the case records, we made consensus diagnoses of various forms and degrees of mother infant relationship disorder, according to criteria published in this paper. We calculated specificity, sensitivity and positive predictive value of the four scale scores generated by the questionnaire. Scale 1 (a general factor) had a sensitivity of 0.82 for all mother-infant relationship disorders. Scale 2 (rejection and pathological anger) had a sensitivity of 0.88 for rejection of the infant, but only 0.67 for severe anger. The performance of scale 3 (infant-focused anxiety) was unsatisfactory. Scale 4 (incipient abuse) selected only a few mothers, but was of some value in identifying those at high risk of child abuse. Revision of the thresholds can improve sensitivity, especially of scale 2, where a cut-off point of 12 = normal, 13 = high better identifies mothers with threatened rejection. These new cut-off points would need validation in another sample.
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                Author and article information

                Journal
                EJOP
                Eur J Psychol
                Europe's Journal of Psychology
                Eur. J. Psychol.
                PsychOpen
                1841-0413
                18 November 2016
                : 12
                : 4
                : 604-621
                Affiliations
                [a ]Centro di Ricerca sulle Dinamiche evolutive ed educative (CRIdee), Department of Psychology, Catholic University of Milan, Milan, Italy
                [b ]Neonatal Intensive Care Unit (NICU), V. Buzzi-Ospedale dei Bambini, ICP, Milan, Italy
                [3]VA Boston Healthcare System (Massachusetts Veterans Epidemiology Research and Information Center) Boston, MA, USA
                Author notes
                [* ]CRIdee, Catholic University of Milan, Largo Gemelli, 1, 20123 Milano, Italy. chiara.ionio@ 123456unicatt.it
                Article
                ejop.v12i4.1093
                10.5964/ejop.v12i4.1093
                5114875
                27872669
                15855eab-1d31-40ca-af33-e88b4d89769f
                Copyright @ 2016

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 December 2015
                : 07 July 2016
                Categories
                Research Reports

                Psychology
                parental stress,caring,parenting,NICU,prematurity
                Psychology
                parental stress, caring, parenting, NICU, prematurity

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