Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care
Postpartum depression (PPD), postpartum anxiety (PPA), and post-traumatic stress disorder (PTSD) among birthing people have increased substantially, contributing to adverse maternal/infant dyad outcomes, with a high prevalence in the neonatal intensive care unit (NICU). Despite calls for trauma-info...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/9/1477 |
| _version_ | 1827726791761985536 |
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| author | Allison Williams Anna Beth Parlier-Ahmad Erin Thompson Rachel Wallace Paul B. Perrin Alyssa Ward Karen D. Hendricks-Muñoz |
| author_facet | Allison Williams Anna Beth Parlier-Ahmad Erin Thompson Rachel Wallace Paul B. Perrin Alyssa Ward Karen D. Hendricks-Muñoz |
| author_sort | Allison Williams |
| collection | DOAJ |
| description | Postpartum depression (PPD), postpartum anxiety (PPA), and post-traumatic stress disorder (PTSD) among birthing people have increased substantially, contributing to adverse maternal/infant dyad outcomes, with a high prevalence in the neonatal intensive care unit (NICU). Despite calls for trauma-informed care in the NICU and high rates of post-traumatic stress, little research has examined the rates of or the relationships between peripartum mood and adverse child experiences (ACEs) in NICU mothers or evaluated which peripartum traumas are most distressing. This study employed structural equation modeling (SEM) to explore whether peripartum-related traumas and NICU-related stressors mediated the associations between ACEs and mental health outcomes in 119 lower-income, racially diverse mothers in a Level IV NICU. Mental health concerns were prevalent and highly comorbid, including 51.3% PPA, 34.5% PPD, 39.5% post-traumatic stress, and 37% with ≥4 ACEs. The majority (53.8%) of mothers endorsed multiple peripartum traumas; NICU admission was the most common trauma (61%), followed by birth (19%), pregnancy (9%), and a medical event in the NICU (9%). Our SEMs had good fit and demonstrated that ACEs predicted peripartum distress. Trauma-informed care efforts should employ transdiagnostic approaches and recognize that women commonly present to the NICU with childhood trauma history and cumulative peripartum traumas. |
| first_indexed | 2024-03-10T22:55:51Z |
| format | Article |
| id | doaj.art-ff0fd12e139d4a7e8715c18be9c56692 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T22:55:51Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-ff0fd12e139d4a7e8715c18be9c566922023-11-19T10:03:02ZengMDPI AGChildren2227-90672023-08-01109147710.3390/children10091477Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed CareAllison Williams0Anna Beth Parlier-Ahmad1Erin Thompson2Rachel Wallace3Paul B. Perrin4Alyssa Ward5Karen D. Hendricks-Muñoz6Department of Psychiatry, Virginia Commonwealth University Medical Center, Richmond, VA 23298, USADepartment of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USACenter for Children and Families, Florida International University, Miami, FL 33199, USADepartment of Psychology, Hunter Holmes McGuire VA Medical Center, Richmond, VA 23249, USADepartment of Psychology, University of Virginia, Charlottesville, VA 22903, USADepartment of Neonatology, Virginia Commonwealth University Medical Center, Richmond, VA 23298, USADepartment of Neonatology, Virginia Commonwealth University Medical Center, Richmond, VA 23298, USAPostpartum depression (PPD), postpartum anxiety (PPA), and post-traumatic stress disorder (PTSD) among birthing people have increased substantially, contributing to adverse maternal/infant dyad outcomes, with a high prevalence in the neonatal intensive care unit (NICU). Despite calls for trauma-informed care in the NICU and high rates of post-traumatic stress, little research has examined the rates of or the relationships between peripartum mood and adverse child experiences (ACEs) in NICU mothers or evaluated which peripartum traumas are most distressing. This study employed structural equation modeling (SEM) to explore whether peripartum-related traumas and NICU-related stressors mediated the associations between ACEs and mental health outcomes in 119 lower-income, racially diverse mothers in a Level IV NICU. Mental health concerns were prevalent and highly comorbid, including 51.3% PPA, 34.5% PPD, 39.5% post-traumatic stress, and 37% with ≥4 ACEs. The majority (53.8%) of mothers endorsed multiple peripartum traumas; NICU admission was the most common trauma (61%), followed by birth (19%), pregnancy (9%), and a medical event in the NICU (9%). Our SEMs had good fit and demonstrated that ACEs predicted peripartum distress. Trauma-informed care efforts should employ transdiagnostic approaches and recognize that women commonly present to the NICU with childhood trauma history and cumulative peripartum traumas.https://www.mdpi.com/2227-9067/10/9/1477postpartum mental healthNICU infantpost-traumatic stressadverse childhood experiences |
| spellingShingle | Allison Williams Anna Beth Parlier-Ahmad Erin Thompson Rachel Wallace Paul B. Perrin Alyssa Ward Karen D. Hendricks-Muñoz Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care Children postpartum mental health NICU infant post-traumatic stress adverse childhood experiences |
| title | Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care |
| title_full | Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care |
| title_fullStr | Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care |
| title_full_unstemmed | Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care |
| title_short | Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care |
| title_sort | peripartum traumas and mental health outcomes in a low income sample of nicu mothers a call for family centered trauma informed care |
| topic | postpartum mental health NICU infant post-traumatic stress adverse childhood experiences |
| url | https://www.mdpi.com/2227-9067/10/9/1477 |
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