https://doi.org/10.4081/scenario.2024.578
COVID-19 pandemic impact on mothers of preterm newborns in NICU: observational study on experiences and maternal-infant attachment
Submitted: 11 January 2024
Accepted: 27 March 2024
Published: 9 April 2024
Accepted: 27 March 2024
Abstract Views: 174
PDF (Italiano): 131
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Introduction: the COVID-19 pandemic caused significant variations in health services and care pathways. Severe access restrictions to NICUs increased the risk of maternal-infant attachment breakdown.
Aim: to investigate the experiences of mothers of preterm infants admitted to NICUs during the pandemic.
Materials and methods: an observational study of mothers of preterm infants was conducted in a NICU in Naples from June 2021 to March 2022. Data were collected during and after hospitalization using two questionnaires and four evaluation scales.
Results: the results showed that more than 90% of the mothers suffered from post-traumatic stress disorder. Situational stress was high across all measured indices. The perceived nursing support was 3.57/5, and the postnatal maternal attachment was 82.95/93.
Discussion: stress and difficulty managing emotions had a significant negative impact on the mothers and their parental role; however, the nursing care received facilitated the development of a positive attachment with the newborn.
Conclusions: neonatal nurses provided valuable human and professional support to mothers of preterm infants. In the future, it will be necessary to implement organizational models that aim to reduce the separation of parents and infants.
World Health Organization. Born too soon: the global action report on preterm birth. 2012.
Polloni L, Cavallin F, Lolli E, et al D. Psychological wellbeing of parents with infants admitted to the neonatal intensive care unit during SARS-CoV-2 pandemic. Children (Basel) 2021;8:755.
Ionio C, Colombo C, Brazzoduro V, et al. Mothers and fathers in NICU: the impact of preterm birth on parental distress. Eur J Psychol 2016;12:604-21.
Ionio C, Mascheroni E, Colombo C, et al. Stress and feelings in mothers and fathers in NICU: identifying risk factors for early interventions. Prim Health Care Res Dev 2019;20:e81.
Al Maghaireh DF, Abdullah KL, Chan CM, et al. Systematic review of qualitative studies exploring parental experiences in the Neonatal intensive care unit. J Clinical Nursing 2016;25:2745-56.
Kotlar B, Gerson EM, Petrillo S, et al. The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review. Reprod Health 2021;18:10.
Beheshtipour N, Baharlu SM, Montaseri S, Razavinezhad Ardakani SM. The effect of the educational program on Iranian premature infants' parental stress in a neonatal intensive care unit: a double-blind randomized controlled trial. Int J Community Based Nurs Midwifery 2014;2:240-50.
Trumello C, Candelori C, Cofini M, et al. Mothers' depression, anxiety, and mental representations after preterm birth: a study during the infant's hospitalization in a neonatal intensive care unit. Front Public Health 2018;6:359.
Bowlby J. Attachment and Loss. Vol. 1. New York, NY: Basic Books. 1969.
Bembich S, Tripani A, Mastromarino S, et al. Parents experiencing NICU visit restrictions due to COVID-19 pandemic. Acta Paediatr 2021;110:940-1.
Cardona JAM, Salazar JKC. Implicaciones de la restricción de las visitas familiares por la pandemia por COVID-19 y el crecimiento-desarrollo del prematuro en la Unidad de Cuidados Intensivos. Atencion Primaria 2021;53:101971.
Wang Y, Chen L, Wu T, et al. Impact of COVID-19 in pregnancy on mother's psychological status and infant's neurobehavioral development: a longitudinal cohort study in China. BMC Med 2020;18:347.
Mayopoulos GA, Ein-Dor T, Dishy GA, et al. COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. J Affect Disord 2021;282:122-5.
Tscherning C, Sizun J, Kuhn P. Promoting attachment between parents and neonates despite the COVID-19 pandemic. Acta Paediatr 2020;109:1937-43.
Cameron EE, Joyce KM, Delaquis CP, et al. Maternal psychological distress & mental health service use during the COVID-19 pandemic. J Affect Disord 2020;276:765-74.
Davenport MH, Meyer S, Meah VL, et al. Moms are not OK: COVID-19 and maternal mental health. Front Glob Womens Health 2020;1:1.
Davis-Floyd R, Gutschow K, Schwartz DA. Pregnancy, birth and the COVID-19 pandemic in the United States. Med Anthropol 2020;39:413-27.
Ahmad M, Vismara L. The psychological impact of COVID-19 pandemic on women's mental health during pregnancy: a rapid evidence review. Int J Environ Res Public Health 2021;18:7112.
Coussons-Read ME. Effects of prenatal stress on pregnancy and human development: mechanisms and pathways. Obstet Med 2013;6:52-7.
Darcy Mahoney A, White RD, Velasquez A, et al. Impact of restrictions on parental presence in neonatal intensive care units related to coronavirus disease 2019. J Perinatol 2020;40:36-46.
Baldoni F, Ancora G, Latour JM. Being the father of a preterm-born child: contemporary research and recommendations for NICU staff. Front Pediatr 2021;9:724992.
Lavizzari A, Klingenberg C, Profit J, et al. International comparison of guidelines for managing neonates at the early phase of the SARS-CoV-2 pandemic. Pediatr Res 2021;89:940-51.
Craig JW, Glick C, Phillips R, et al. Recommendations for involving the family in developmental care of the NICU baby. J Perinatol 2015;35:S5-8.
Fallon V, Davies SM, Silverio SA, et al. Psychosocial experiences of postnatal women during the COVID-19 pandemic. A UK-wide study of prevalence rates and risk factors for clinically relevant depression and anxiety. J Psychiatr Res 2021;136:157-66.
Flacking R, Lehtonen L, Thomson G, et al. Separation and Closeness Experiences in the Neonatal Environment (SCENE) group. Closeness and separation in neonatal intensive care. Acta Paediatr 2012;101:1032-7.
Lorenzi Quigley, L. Impact of a NICU bedside reading initiative on self-reported maternal stress and mother-infant attachment. 2020, Doctoral dissertation, Duquesne University. Disponibile presso: https://dsc.duq.edu/etd/1946
Furlow B. US NICUs and donor milk banks brace for COVID-19. Lancet Child Adolesc Health 2020;4:355.
Epstein EG, Arechiga J, Dancy M, et al. Integrative review of technology to support communication with parents of infants in the NICU. J Obstet Gynecol Neonatal Nurs 2017;46:357-66.
Lu D, Sang L, Du S, et al. Asymptomatic COVID-19 infection in late pregnancy indicated no vertical transmission. J Med Virol 2020;92:1660-64.
Weiss DS, Marmar CR. The impact of event scale – revised. In: Wilson JP, Keane TM, editors. Assessing Psychological Trauma and PTSD. New York: Guilford Press; 1997:399–411.
Craparo G, Faraci P, Rotondo G, Gori A. The Impact of Event Scale - Revised: psychometric properties of the Italian version in a sample of flood victims. Neuropsychiatr Dis Treat 2013;9:1427-32.
Miles MS, Carlson J, Brunssen S. The nurse parent support tool. J Pediatr Nurs 1999;14:44-50.
Montirosso R, Provenzi L, Calciolari G, et al. Measuring maternal stress and perceived support in 25 Italian NICUs. Acta Paediatr 2012;101:136-42.
Miles MS, Funk SG, Carlson J. Parental Stressor Scale: neonatal intensive care unit. Nurs Res 1993;42:148-52.
Condon JT, Corkindale CJ. The assessment of parent-to-infant attachment: Development of a self-report questionnaire instrument. J Reproduct Infant Psychol 1998;16:57-76.
Scopesi A, Viterbori P, Sponza S, Zucchinetti P. Assessing mother‐to‐infant attachment: the Italian adaptation of a self‐report questionnaire. J Reproductive Infant Psychol 2004;22:99-109.
Wong CK, Yip BH, Mercer S, et al. Effect of facemasks on empathy and relational continuity: a randomised controlled trial in primary care. BMC Fam Pract 2013;14:200.
Ionio C, Lista G, Mascheroni E, et al. Premature birth: complexities and difficulties in building the mother-child relationship. J Reprod Infant Psychol 2017;35:509-23.
Hugelius K, Harada N, Marutani M. Consequences of visiting restrictions during the COVID-19 pandemic: An integrative review. Int J Nurs Stud 2021;121:104000.
Manuela F, Barcos-Munoz F, Monaci MG, et al. Maternal stress, depression, and attachment in the neonatal intensive care unit before and during the COVID pandemic: an exploratory study. Front Psychol 2021;12:734640.
Kirolos S, Sutcliffe L, Giatsi Clausen M, et al. Asynchronous video messaging promotes family involvement and mitigates separation in neonatal care. Arch Dis Child Fetal Neonatal Ed 2021;106:172-7.
De Bernardo G, Napoletano G, Sordino D, et al. Improving care in neonatal intensive units during the COVID-19 pandemic: a survey on electronic health communication. J Intensive Care Med 2022;37:671-8.
How to Cite
Piccolo, R., El Sayed, S., & Bove, D. (2024). COVID-19 pandemic impact on mothers of preterm newborns in NICU: observational study on experiences and maternal-infant attachment. Scenario® - Il Nursing Nella Sopravvivenza, 41(1). https://doi.org/10.4081/scenario.2024.578
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