C. Sanner1, E. Lima1, K. H. Parker1, A. Lavery2, E. Perrone3, C. L. Neece1, E. P. Tagge3 1Loma Linda University,Behavioral Medicine,Loma Linda, CA, USA 2Loma Linda University Children’s Hospital,Pediatrics,Loma Linda, CA, USA 3Loma Linda University Children’s Hospital,Pediatric Surgery/Surgery,Loma Linda, CA, USA
Introduction:
Prenatal counseling attempts to educate families about diagnoses, likely outcomes and potential management options for their unborn child. An assumed additional benefit is to provide psychosocial support to parents, thus ameliorating emotional distress. Many authors have stated that prenatal counseling limits stress on both parent and baby. However objective documentation of such stress reduction is difficult to find. Taking advantage of our large prospective database on NICU parental mental health factors, we sought to examine the impact of prenatal counseling on a variety of psychology parameters.
Methods:
Data were abstracted from a large prospective data set created to examine the relationship between parental mental health and NICU infant outcomes. Parents of our Level III NICU infants completed an hour-long questionnaire which included basic demographic questions as well as a variety of validated psychological instruments including 1) The Brief COPE Inventory; 2) Parental Stressor Scale: NICU (PSS: NICU); 3) The Psychological Well-Being Scale; 4) The Pediatric Inventory for Parenting (PIP); 5) Center for Epidemiologic Studies-Depression Scale (CES-D); 6) Stanford Acute Stress Questionnaire.
Results:
Completed questionnaires from parents of 77 infants managed in our Level III NICU were analyzed. The majority of the families were low income, less than half of the mothers were married and the majority of parents disclosed that their pregnancy was not planned. The mean CES-D depression score indicated that large portion of parents endorsed clinical levels of depression. A large percentage of parents met the clinical cut-offs for the hallmark symptoms of Acute Stress Disorder: dissociation (9.5%), anxiety (66.7%), avoidance (23.8%), and re-experiencing (28.6%). Parents endorsed a mean stress level score of 2.52 on the 4-point PSS: NICU scale, indicating moderate to high levels of stress. When patients were compared (one way anova) between prenatal counseling and no prenatal counseling, there was no significant difference in the results of the Stanford Acute Stress Questionnaire, the CES-D score, none of the 4 subscales of the PIP, coping mechanisms as evaluated in the Brief Cope Inventory, or overall stress as measured by the PSS:NICU.
Conclusion:
Significant mental health issues exist among parents of NICU babies, particularly depression and high stress levels. Prenatal counseling was not seen to impact any of a variety of psychology evaluations. This data suggests that perinatologists and pediatric surgeons should consider referring families for psychology support services if there is significant emotional distress noted at their prenatal counseling visit.