Mass General Hospital

Harvard Medical School

Infants in the NICU: High Risk for PTSD in First-Time Mothers

Having a newborn child in the neonatal intensive care unit (NICU) is understandably stressful.  Previous studies have demonstrated that mothers in this setting are at increased risk for postpartum depression (PPD).  In addition, a recent study indicates that rates of post-traumatic disorder (PTSD) are very high in this population. 

In this study from South Korea, the researchers collected self-reported psychological data from 130 mothers of NICU babies and 53 mothers of babies not admitted to the NICU.  The mothers were assessed at 1, 3 and 12 months after delivery.

25% of the NICU mothers had PTSD symptoms compared to 9% of the controls.  Four distinct PTSD patterns were identified: none (67%), persistent (9%, symptoms at all time points), delayed (9%, symptoms detected only after 3 months) and recovered (15%, symptoms resolved by 3 months).

In terms of risk factors, PTSD was more common among women who reported anxiety symptoms prior to pregnancy.  First time mothers were also much more vulnerable to PTSD and were 7.6 times more likely to report PTSD symptoms than mothers who had more than one child.

It is no surprise that women with infants in the NICU are more vulnerable to PTSD.  Probably the most important finding from this study is that risk for PTSD may persist, often extending long after the infant has been discharged from the NICU.  Also of note is the observation that about 10% of the women had a delayed onset (after 3 months) of PTSD symptoms.    

In many cases, there are medical issues that persist beyond the baby’s stay in the NICU, and parents can feel tremendously overwhelmed by the demands of caring for a baby who is medically ill when they return home. Thus, we should screen for PTSD symptoms in mothers who have children in the NICU, but we should also understand that this population of women remain at significant risk for PTSD even after their children leave the hospital.

Ruta Nonacs, MD PhD

Kim WJ, Lee E, Kim KR, et al.  Progress of PTSD symptoms following birth: a prospective study in mothers of high-risk infants.  J Perinatol. 2015 Apr 9.  [Epub ahead of print]

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