Duration of Maternal Stress and Depression Predictors of Newborn Admission to Neonatal Intensive Care Unit and Postpartum Depression

被引:33
作者
Latendresse, Gwen [1 ]
Wong, Bob [2 ]
Dyer, Jane [1 ]
Wilson, Barbara [1 ]
Baksh, Laurie [3 ]
Hogue, Carol [4 ]
机构
[1] Univ Utah, Coll Nursing, Salt Lake City, UT 84112 USA
[2] Univ Utah, Coll Nursing, Appl Stat, Salt Lake City, UT 84112 USA
[3] Utah Dept Hlth, Maternal & Infant Hlth Program, Salt Lake City, UT 84116 USA
[4] Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
关键词
depression; newborn intensive care; postpartum depression; prenatal stress; INTIMATE PARTNER VIOLENCE; LOW-BIRTH-WEIGHT; PRETERM BIRTH; PSYCHOSOCIAL STRESS; PERINATAL OUTCOMES; PREGNANCY OUTCOMES; RISK; IMPACT; HEALTH; DISPARITIES;
D O I
10.1097/NNR.0000000000000117
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Background Maternal psychosocial factors contribute to adverse pregnancy outcome, but very few studies have assessed associations of duration and experiences of stress, depression, and intimate partner violence (IPV) with maternal and newborn outcomes. Objectives It was hypothesized that duration and level of maternal stress, depression, and IPV would predict increased risk of adverse maternal/newborn outcomes. Methods A secondary data analysis of a population-based data set collected by the Utah Department of Health Pregnancy Risk Assessment and Monitoring System and birth certificates for 4682 live births was conducted, reflecting a total population size of 143,373 live births in 2009-2011. Exposures of interest were experiences and duration of maternal stress, depression, and IPV before and during pregnancy. Outcomes were gestational age, birth weight, newborn admission to the neonatal intensive care unit (NICU), and postpartum depression (PPD) symptoms and diagnosis. Results After controlling for maternal demographics, body mass index, and smoking, women with greater duration of depression before and during pregnancy showed an increase in admission of their newborn to NICU (adjusted odds ratios [aORs] = 1.66-2.48, p < .001), PPD symptoms (aORs = 3.94-9.13, p < .001), and diagnosis of PPD (aORs = 7.72-59.60, p < .001). More kinds of experiences of maternal stress were associated with higher odds of PPD symptoms (aORs = 1.34-5.51, p < .001), but not PPD diagnosis or NICU admissions. Discussion Longer lasting maternal depression and stress are associated with poorer outcomes for mothers and newborns. Future prospective studies should evaluate the usefulness of preconception and continuous prenatal risk identification of maternal depression and stress. This would facilitate timely psychosocial interventions as an approach to improving maternal/newborn outcomes for these higher risk women.
引用
收藏
页码:331 / 341
页数:11
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