CLINICAL RESEARCH
Posttraumatic Stress Symptoms in Mothers of Premature Infants

https://doi.org/10.1177/0884217503252035Get rights and content

Objective:

To examine mothers’ responses to having a premature infant in the neonatal intensive-care unit and to determine the degree to which they appear similar to a posttraumatic stress response.

Design:

Mothers were enrolled in this descriptive, correlational study shortly before the infant was discharged from the hospital. Data were collected at enrollment and when the infant was 6 months old, corrected for prematurity.

Participants:

A convenience sample of 30 mothers of high-risk premature infants.

Interventions:

None.

Main Outcome Measures:

A semistructured interview of the mothers was conducted at 6 months corrected age. Interview responses were analyzed to identify three symptoms related to posttraumatic stress disorder: re-experiencing, avoidance, and increased arousal. Other measures focused on maternal psychological well-being—neonatal intensive-care unit stress, depressive symptoms, and worry about the infant—and demographic characteristics. Infant illness severity included birth weight, length of mechanical ventilation, multiple birth, and the severity of neurological insults.

Results:

All mothers interviewed had at least one posttraumatic symptom, 12 had two, and 16 had three symptoms. Twenty-six mothers reported increased arousal; re-experiencing and avoidance were reported by 24 mothers each. The number, but not the type, of posttraumatic stress symptoms was related to maternal psychological well-being. Maternal demographic characteristics, except marital status, and infant illness severity, were unrelated to posttraumatic stress symptoms.

Conclusions:

These mothers appeared to be experiencing emotional responses similar to posttraumatic stress reactions at 6 months after their child's expected birth date. Since maternal emotional responses may affect the parenting of premature infants, additional nursing research is needed to provide a basis for interventions with these highly vulnerable mothers and infants.

Section snippets

Participants

Participants in the current study were a convenience sample of 30 mothers of premature infants enrolled in a larger study of a nursing support intervention (Holditch-Davis & Miles, 2000; Holditch-Davis, Miles, & Belyea, 2000). The infants were all patients in a tertiary, university-based NICU and were selected because they were at high risk for developmental problems, either due to their birth weight being less than 1,500 g or their having medical problems requiring mechanical ventilation. All

Results

All of the mothers interviewed had at least one post-traumatic symptom, 12 had two symptoms, and 16 had three symptoms. Increased arousal was reported by 26 mothers; avoidance and re-experiencing were each reported by 24 mothers.

Discussion

Thus, 6 months after their infants’ expected birth dates, most of the mothers of high-risk premature infants interviewed appeared to be experiencing emotional responses consistent with posttraumatic stress reactions. All mothers in this study had at least one posttraumatic symptom, and more than half had all three symptoms (reexperiencing the event, avoidance of reminders or numbing, and increased arousal). The number, but not the type, of posttraumatic symptoms was related to maternal

Acknowledgments

The preparation of this article was partially supported by the National Institute for Nursing Research, National Institutes of Health, as part of research support center grant (P30 NR03962), and, for the second and third authors, by a Predoctoral Fellowship: Institutional National Service Award from the University of North Carolina at Chapel Hill School of Nursing (T32 NR07091).

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