Poster #59 - Maternal and paternal emotional reaction to premature birth: a serial multiple mediator model

• In Event: 2-055 - Poster Session 06
  In Poster Session: PS 06 Section - Developmental Psychopathology

Integrative Statement

Introduction: The birth of a premature infant is a stressful event in family's life. Many studies have shown that parents of these infants are at risk for psychological distress during NICU hospitalization. Mothers have reported feelings of sadness, helplessness, and guilt over delivering before term, high levels of uncertainty about the baby's medical condition, and mental distress due to separation in the NICU. Additionally, parents may continue to experience distress during the early years after birth. Thus, to better understand the risk of psychological distress associated with preterm birth, the environment must be considered. Accordingly, we propose that the way each parent experiences preterm birth may affect and be affected by how the other parent emotionally adapts to the newborn’s birth.
Aims: To investigate early markers of maternal emotional adjustment following the birth of a preterm infant. Specifically, to examine how child medical condition and paternal and maternal early distress act together in the prediction of maternal emotional adjustment during the newborn’s first year of life. We hypothesize that neonatal risk will indirectly influence maternal emotional distress over time, through multiple mediators of mothers' and fathers’ postpartum emotional distress and fathers’ emotional distress six months later.
Method: Our sample comprised 60 preterm infants (28 to 34 weeks of gestation) and their parents. To determine neonatal risk, clinical data were collected prior to infant discharge from the NICU, including gestational age and birth weight, the number of days hospitalized in NICU, and Apgar score. Infant’s neurobiological risk was determined using Nursery Neurobiological Risk Score – short version (NBRSR; Brazy, Eckerman, Oehler, Goldstein, & O'Rand, 1991). These variables were all loaded on one scale (explaining 58.63% of the variance) and were averaged to create a single factor, “neonatal risk.” To assess mental distress, parental data were collected at birth, at 6 months, and at 12 months of newborn’s age. Parents completed a self-report measure of depressive symptoms using the 20-item Center for Epidemiologic Studies Depression (CES-D) scale (Radloff, 1977) and a measure of trait anxiety using the 20-item State-Trait Anxiety Inventory (STAI; Spielberger, 1983).
Results: Multiple serial mediation models were tested. Results indicated that the total effect of neonatal risk on maternal emotional distress over time was significant (b= 0.4430, SE = 0.1633, t = 2.7129, p < .05), and was reduced to a nonsignificant level in the direct model (b= 0.0185, SE = 0.1183, t = 0.1564, p =.8763). Furthermore, this link was significantly mediated by mothers' and fathers’ postpartum emotional distress and by fathers’ emotional distress 6 months later (indirect total effect, b= 0.4245, SE = 0.1183, p < .05).
Conclusion: Newborn’s health affected maternal emotional distress over time. Both mothers’ and also fathers’ initial reactions to the preterm birth seem to explain this link. Thus, intervention programs targeting both parents are important, especially when parents have more worries about their newborn’s health. These results have implications for both research and clinical practice.

Authors

• Reut Baz Zitrin, Ben-Gurion University of the Negev
  Presenting Author

• Noa Gueron-Sela, Ben-Gurion University of the Negev
  Non-Presenting Author

• Gal Meiri, Ben Gurion university of the Negev
  Non-Presenting Author

• Kyla Marks, Ben Gurion university
  Non-Presenting Author

• Naama Atzaba-Poria, Ben-Gurion University of the Negev
  Non-Presenting Author