University of Kentucky

Impact of Prenatal Psychosocial Wellness on Risk for NICU Admission

Institution

University of Kentucky

Abstract

Kentucky ranks among the top 5 states for preterm births (13.4%). Psychosocial health (depressive symptoms, stress and anxiety) can negatively impact perinatal outcomes. The purpose of this study is to determine the relationship between adverse infant outcomes (Neonatal Intensive Care Unit (NICU) admission) and prenatal depressive symptoms, stress and anxiety scores measured throughout each trimester of pregnancy. This is a secondary data analysis of a prospective trial of pregnant women (n= 252) with single gestation. Women completed the Edinburgh Postnatal Depression Scale, (EPDS), Everyday Stressors Scale (ESS), and the State Trait Anxiety Index (STAI) during each trimester of pregnancy. Positive depressive symptoms were defined as a score > 10. Maternal anxiety and stress were measured continuously. Twelve percent of infants were admitted to NICU (n =31). First trimester anxiety and depressive symptoms were significantly associated with NICU admission (p =.04; p =.005, respectively); however, but not associated in the second or third trimester. In all trimesters, mean anxiety scores were consistently higher in women whose infants were admitted to NICU compared to women who delivered healthy, term infants (1st: 42.7 vs. 35.7; 2nd: 38.6 vs. 34.2; 3rd: 31.6 vs. 35.5). High maternal anxiety and depressive symptoms in the first trimester are associated with NICU admission. Obstetric nurses need to follow a psychosocial screening protocol to identify and treat women throughout pregnancy to reduce risk for adverse maternal and infant outcomes, including NICU admission.

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Impact of Prenatal Psychosocial Wellness on Risk for NICU Admission

Kentucky ranks among the top 5 states for preterm births (13.4%). Psychosocial health (depressive symptoms, stress and anxiety) can negatively impact perinatal outcomes. The purpose of this study is to determine the relationship between adverse infant outcomes (Neonatal Intensive Care Unit (NICU) admission) and prenatal depressive symptoms, stress and anxiety scores measured throughout each trimester of pregnancy. This is a secondary data analysis of a prospective trial of pregnant women (n= 252) with single gestation. Women completed the Edinburgh Postnatal Depression Scale, (EPDS), Everyday Stressors Scale (ESS), and the State Trait Anxiety Index (STAI) during each trimester of pregnancy. Positive depressive symptoms were defined as a score > 10. Maternal anxiety and stress were measured continuously. Twelve percent of infants were admitted to NICU (n =31). First trimester anxiety and depressive symptoms were significantly associated with NICU admission (p =.04; p =.005, respectively); however, but not associated in the second or third trimester. In all trimesters, mean anxiety scores were consistently higher in women whose infants were admitted to NICU compared to women who delivered healthy, term infants (1st: 42.7 vs. 35.7; 2nd: 38.6 vs. 34.2; 3rd: 31.6 vs. 35.5). High maternal anxiety and depressive symptoms in the first trimester are associated with NICU admission. Obstetric nurses need to follow a psychosocial screening protocol to identify and treat women throughout pregnancy to reduce risk for adverse maternal and infant outcomes, including NICU admission.