Impact of maternal stressors and neonatal clinical factors on post-partum depression screening scores

Background: Higher rates of postpartum depression (PPD) are reported in mothers of neonatal intensive care unit (NICU) hospitalized infants. The relationship of neonatal clinical risk factors and self-reported maternal stress levels to positive PPD screening is not well characterized. Objective: To determine the feasibility of postpartum depression screening in a regional perinatal center, and assess the association of NICU-specific comorbidities and maternal stress levels with PPD screening scores. Design/Methods: Prospective study of mothers of NICU-hospitalized infants conducted between 21and 30 days of their infant's life. Mothers completed the Edinburgh Postpartum Depression scale (EPDS) and the Parental Stressor Scale: NICU (PSS: NICU) in the environmental, infant behavior and parental domains. Total EPDS scores and positive PPD screening were correlated with NICU comorbidities, demographic factors and PSS: NICU scores. Results: The incidence of positive PPD screening was 19% (25/135). In bivariate analysis, positive PPD screen was associated with exclusive breastfeeding (67% vs, 35%, p < .05) and maternal age <35 years (32% vs. 12%, p < .05). No observed differences in maternal and infant demographic factors or neonatal comorbidities were seen in mothers with positive PPD screening. Mean PPD screening scores were higher in infants with intraventricular hemorrhage of any grade and necrotizing enterocolitis. In adjusted analysis, overall and domain-specific PSS: NICU scores were associated with positive PPD screening. Conclusion: Cumulatively and within each PSS: NICU domain, parental stress correlated with positive PPD screening but was unrelated to NICU comorbidities. Reducing modifiable factors which exacerbate parental stress may impact the incidence of positive PPD screening among NICU mothers.

Automated summary

Mothers of infants in the neonatal intensive care unit (NICU) have higher rates of postpartum depression (PPD). Factors associated with positive PPD screening include exclusive breastfeeding and maternal age <35 years. There were no observed differences in maternal and infant demographic factors or neonatal comorbidities in mothers with positive PPD screening. Parental stress, especially within the NICU domain, was associated with positive PPD screening.