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Release Date: 09/13/2016

Postpartum depression is the most common complication of pregnancy and childbirth, affecting up to 15 percent of all women within the first three months following delivery. Research has shown that mothers of infants born prematurely have almost double the rates of postpartum depression, particularly during their time in the neonatal intensive care unit (NICU).

Research led by Betty R. Vohr, MD, director of Women & Infants’ Neonatal Follow-Up Program and professor of pediatrics at The Warren Alpert Medical School of Brown University, found that there are certain social and emotional factors that further increase the risk of postpartum depression in mothers of preterm infants. The research, entitled “Social Emotional Factors Increase Risk of Postpartum Depression in Mothers of Preterm Infants,” has been published in The Journal of Pediatrics. Lead author is Katheleen Hawes, PhD, RN, of the Center for Children and Families at Women & Infants Hospital of Rhode Island and assistant professor (adjunct) in the Department of Pediatrics at the Alpert Medical School.

“We found mothers with a previous mental health disorder and experiencing negative perceptions of herself and her infant at NICU discharge were at increased risk for depression one month post discharge, regardless of the infant’s gestational age at birth,” explained Hawes.  

The study included 724 mothers of preterm infants who were cared for more than five days in the NICU and participated in a Transition Home Program. Families in the program received enhanced support and education about their infants from former NICU parents trained as family resource specialists. Participants completed an evaluation prior to discharge to determine their perceptions of NICU staff support, infant well-being, maternal well-being (emotional readiness/competency), and maternal comfort (worry about her infant). Mental health history and social risk factors were also obtained by the researchers. At one month post discharge, the Edinburgh Postnatal Depression Scale was administered.

Hawes said, “Mothers of early, moderate and late preterm infants reported similar rates of possible depression – 20%, 22% and 18% respectively – one month after NICU discharge. A history of mental health disorder, decreased perception of maternal well-being, decreased maternal comfort regarding her infant, and decreased perception of family cohesion were also associated with possible depression at one month post discharge.”

Hawes and her colleagues concluded that comprehensive mental health assessment prior to discharge is essential to identify women at risk and provide appropriate referrals. She said, “Comprehensive transition home assessment and interventions to reduce anxiety and bolster maternal mental health, confidence and readiness, along with post discharge assessment, are needed to identify, treat and support mothers of preterm infants.”

The research team also included Women & Infants/Brown University colleagues Elisabeth McGowan, MD; Melissa O’Donnell, MSW; and Richard Tucker, BA.

About Women & Infants Hospital

Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women’s medicine, Women & Infants is the 9th largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,500 deliveries per year. A Designated Baby-Friendly® USA hospital, U.S.News & World Report 2014-15 Best Children’s Hospital in Neonatology and a 2014 Leapfrog Top Hospital, in 2009 Women & Infants opened what was at the time the country’s largest, single-family room neonatal intensive care unit.

Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation’s first mother-baby perinatal psychiatric partial hospital, as well as the nation’s only fellowship program in obstetric medicine.

Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center of Biomedical Research Excellence by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute’s Gynecologic Oncology Group and the Pelvic Floor Disorders Network.
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