Ozdil Mine
Department of Pediatrics, Division of Neonatology, University of Health Sciences, Balıkesir Atatürk City Hospital, Balıkesir, TUR.
Cureus. 2023 Aug 30;15(8):e44380. doi: 10.7759/cureus.44380. eCollection 2023 Aug.
Background Neonatal intensive care unit (NICU) hospitalization of newborn babies has been shown to have a negative impact on the mental health of postpartum women. The mental health of new mothers may be further burdened by the effects of the coronavirus disease 2019 (COVID-19) pandemic on social, economic, and psychological dimensions. This study aimed to evaluate postpartum depression and related factors in mothers of infants hospitalized in NICU during two distinct COVID-19 pandemic periods and examine any additional effects of the pandemic on the mental health of postpartum women. Methodology The Edinburgh Postpartum Depression Scale (EPDS) was applied to 250 NICU mothers during the COVID-19 pandemic. The first 125 women's children were hospitalized during a period of high number of cases and deaths when restrictions were in place for NICU parental visits (November 2021 to February 2022, the early group). The remaining 125 women completed the scale when there was a lower number of cases and restrictions had been eased (March to June 2022, the late group). Results In the early group, the EPDS scores were statistically higher (7.53.9 vs. 5.63.4; p < 0.001), smoking and NICU stay duration were significantly higher (p = 0.01), whereas the duration of marriage was significantly lower (p = 0.01). Women in the late group with EPDS scores ≥13 were statistically less educated (p = 0.01). EPDS scores ≥13 were significantly associated with depression during pregnancy and with a history of abortion/stillbirth/neonatal death (odds ratio (OR) = 5.240, 95% confidence interval (CI) 1.114 to 27.967, p = 0.03 and OR = 1.641, 95% CI = 1.009 to 2.669, p = 0.04, respectively). Conclusions NICU admission is a significant maternal risk factor for postpartum depression due to the disruption of maternal-infant bonding, and this risk may be exacerbated during times of global public health crises such as the COVID-19 pandemic. Depression during pregnancy and the presence of a perinatal loss may also contribute to worse postpartum mental outcomes in NICU mothers.
新生儿重症监护病房（NICU）收治新生儿已被证明会对产后女性的心理健康产生负面影响。2019冠状病毒病（COVID-19）大流行在社会、经济和心理层面的影响可能会进一步加重新妈妈的心理健康负担。本研究旨在评估在两个不同的COVID-19大流行时期入住NICU的婴儿母亲的产后抑郁及相关因素，并探讨大流行对产后女性心理健康的任何额外影响。方法：在COVID-19大流行期间，对250名NICU母亲应用爱丁堡产后抑郁量表（EPDS）。前125名女性的孩子在病例和死亡人数较多的时期住院，当时NICU限制家长探视（2021年11月至2022年2月，早期组）。其余125名女性在病例数较少且限制放宽时完成该量表（2022年3月至6月，晚期组）。结果：在早期组中，EPDS得分在统计学上更高（7.5±3.9对5.6±3.4；p<0.001），吸烟率和在NICU的住院时间显著更高（p=0.01），而婚姻持续时间显著更低（p=0.01）。晚期组中EPDS得分≥13的女性在统计学上受教育程度更低（p=0.01）。EPDS得分≥13与孕期抑郁以及有流产/死产/新生儿死亡史显著相关（优势比（OR）=5.240，95%置信区间（CI）1.114至27.967，p=0.03；OR=1.641，95%CI=1.009至2.669，p=0.04）。结论：由于母婴联结中断，入住NICU是产后抑郁的一个重要产妇风险因素，在COVID-19大流行等全球公共卫生危机期间，这一风险可能会加剧。孕期抑郁和围产期损失的存在也可能导致NICU母亲产后心理状况更差。
