Posttraumatic stress symptoms in mothers of premature infants

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.