Credentials of Corresponding Author
BS
Name of Faculty Advisor
Thao Griffith, PhD, RN
Problem
Approximately 10% of infants are born before 37 weeks of gestation in the United States, ranking as one of the highest preterm birth rates in the world. Of those preterm infants, 70% are admitted into the Neonatal Intensive Care Unit (NICU). NICU hospitalization induces a significant amount of stress to both the parents and infant. This stress may persist for months to years post NICU discharge.
Purpose
To understand (1) stressors that preterm infants and parents are exposed to during NICU hospitalization; (2) how these stressors affect preterm infants and parents; (3) stressors in parents of preterm infants post NICU discharge.
Search strategy
Literature search via PubMed, CINAHL, and PsycInfo. Keywords included NICU, stress, challenges, mother, father, infant, parental, discharge, premature, and preterm infant.
Results of literature search
Preterm infants often experience painful procedures and routine assessment. They’re exposed to excessive light and noise in the NICU, which disturb the natural sleep cycle and induce stress. Other stressors for infants include removing them from the incubator, multiple attempts of IV insertions, intubation, heel pricks, etc. Parental stress is associated with the anxiety and frustration that results from witnessing their newborn child endure painful procedures. It’s further exacerbated by the powerlessness resulting from the inability to intervene. Upon NICU discharge, stressors include learning to care for a preterm infant, having a technology-dependent infant, challenges with breastfeeding, anxiety about leaving infant with caregivers, difficulty bonding with infant, and a need for emotional/financial support. Parents of preterm infants are at risk for depression, anxiety, and post-traumatic disorders. In addition, parental stress negatively impacts parent-infant bonding, breastfeeding, and the infant’s developmental and health outcomes.
Synthesis of evidence
Preterm infants often experience painful procedures and routine assessment. They’re exposed to excessive light and noise in the NICU, which disturb the natural sleep cycle and induce stress. Other stressors for infants include removing them from the incubator, multiple attempts of IV insertions, intubation, heel pricks, etc. Parental stress is associated with the anxiety and frustration that results from witnessing their newborn child endure painful procedures. It’s further exacerbated by the powerlessness resulting from the inability to intervene. Upon NICU discharge, stressors include learning to care for a preterm infant, having a technology-dependent infant, challenges with breastfeeding, anxiety about leaving infant with caregivers, difficulty bonding with infant, and a need for emotional/financial support. Parents of preterm infants are at risk for depression, anxiety, and post-traumatic disorders. In addition, parental stress negatively impacts parent-infant bonding, breastfeeding, and the infant’s developmental and health outcomes.
Implications for practice
Understanding stressors during NICU hospitalization and how they affect preterm infants and parents is critical. Interventions, i.e, single-family rooms and kangaroo care, may decrease stress among infants and parents. Understanding stressors in parents of preterm infants post NICU discharge may help researchers and clinicians develop targeted education and risk assessment. Targeted education can facilitate optimal parent-infant bonding, increase parental confidence, and prepare parents for the transition home. Future research may test targeted interventions and support to mitigate the negative impacts of NICU stressors.
Oh-my-stress: Enduring Challenges for Preterm Infants and Parents during NICU Hospitalization and Parental Stress Post NICU Discharge