Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC.
Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC.
J Pediatr. 2020 Dec;227:163-169.e1. doi: 10.1016/j.jpeds.2020.07.040. Epub 2020 Jul 15.
To investigate the prevalence and risk factors associated with parental depressive symptoms at neonatal intensive care unit (NICU) discharge and determine the relationships among depressive symptoms, stress, and social support.
Parents participating in the Giving Parents Support trial (n = 300) were surveyed before NICU discharge. Depressive symptoms, stress, and social support were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10), Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU), Perceived Stress Scale (PSS-10), and Multidimensional Scale of Perceived Social Support (MSPSS). Regression analyses examined relationships among depressive symptoms, stress, social support, and parent/infant factors.
At NICU discharge, 45% of parents reported depressive symptoms and 43% reported elevated perceived stress. Increased odds of elevated depressive symptoms were associated with older gestational age (P = .02), female infant (P = .02), and longer length of stay (P = .045). Odds of depression were 7.87 (95% CI, 2.15-28.75) for parents of infants with gestational age ≥37 weeks compared with gestational age <28 weeks. Parental NICU stress was higher in younger parents (P < .01). Depressive symptoms were positively associated with parental stress. Each 1-point increase in PSS:NICU score was associated with a 2.1-point (95% CI, 1.6-2.9; P < .001) increase in CESD-10 score. Social support was inversely associated with depressive symptoms.
The prevalence of depressive symptoms in parents at NICU discharge was high, even among parents of term infants. Older gestational age, greater parental stress, and lower levels of social support were strong correlates of depressive symptoms. Strategies to support parents, including depression screening, stress reduction strategies, and mental health referrals, are needed.
调查新生儿重症监护病房（NICU）出院时父母抑郁症状的流行率和相关风险因素，并确定抑郁症状、压力和社会支持之间的关系。
参与“给予父母支持”试验的父母（n=300）在 NICU 出院前接受了调查。使用流行病学研究中心抑郁量表（CESD-10）、新生儿重症监护病房父母应激量表（PSS：NICU）、感知压力量表（PSS-10）和多维感知社会支持量表（MSPSS）评估抑郁症状、压力和社会支持。回归分析检查了抑郁症状、压力、社会支持和父母/婴儿因素之间的关系。
在 NICU 出院时，45%的父母报告有抑郁症状，43%的父母报告有较高的感知压力。较高的抑郁症状风险与较大的胎龄（P=.02）、女婴（P=.02）和较长的住院时间（P=.045）有关。与胎龄<28 周的婴儿相比，胎龄≥37 周婴儿的父母患抑郁症的风险为 7.87（95%可信区间，2.15-28.75）。年轻父母的 NICU 压力较高（P<.01）。抑郁症状与父母压力呈正相关。PSS：NICU 评分每增加 1 分，CESD-10 评分就会增加 2.1 分（95%可信区间，1.6-2.9；P<.001）。社会支持与抑郁症状呈负相关。
NICU 出院时父母的抑郁症状发生率很高，即使是在足月婴儿的父母中也是如此。较大的胎龄、较大的父母压力和较低的社会支持是抑郁症状的强烈相关因素。需要采取支持父母的策略，包括抑郁筛查、减压策略和精神健康转介。
