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A Pilot Study of Oxytocin in Low-Income Women With a Low Birth-Weight Infant

Is Oxytocin Related to Posttraumatic Stress?

Garfield, Lindsey PhD, WHNP; Holditch-Davis, Diane PhD, RN, FAAN; Carter, C. Sue PhD; McFarlin, Barbara L. PhD, CNM, RDMS, FACNM; Seng, Julia S. PhD, CNM, FAAN; Giurgescu, Carmen PhD, WHNP; White-Traut, Rosemary PhD, RN, FAAN

Section Editor(s): Dowling, Donna

doi: 10.1097/ANC.0000000000000601
Original Research

Background: Negative outcomes related to prematurity may lead to maternal distress. Mothers of premature/low birth-weight infants report increased posttraumatic stress (50%) and depressive symptoms (63%) compared with mothers of full-term infants. Low-income, minority mothers with greater posttraumatic stress and depression have an increased risk for premature/low birth-weight delivery compared with their white counterparts. Variations in the neuropeptide oxytocin are implicated in lactation, perinatal depression, and maternal behavior.

Purpose: To examine the associations among posttraumatic stress, depressive symptoms, and oxytocin in a pilot sample of minority mothers with premature/low birth-weight infants in the neonatal intensive care unit (NICU).

Methods: This study employed a descriptive, correlational pilot design of 8 minority, low-income mothers with premature/low birth-weight infants. Participants answered questionnaires pertaining to posttraumatic stress, depression, lactation, and demographics and oxytocin was measured. This is a substudy that added oxytocin values.

Results: Four participants had elevated depressive symptoms and 5 supplied their own milk. Women who provided their own milk had lower depressive (t = 3.03, P = .023) and posttraumatic stress (t = 3.39, P = .015) symptoms compared with women not supplying their own milk. Women with elevated posttraumatic stress had higher levels of depressive symptoms (r(8) = 0.8, P = .006) and lower levels of oxytocin (r(8) = 0.77, P = .026).

Implications for Practice: These results are congruent with previous literature on providing human milk and maternal mental health. In addition, we found a possible relationship between postpartum posttraumatic stress and oxytocin in minority women with premature/low birth-weight infants. NICU nurses should encourage lactation and assess mothers for posttraumatic stress and depressive symptoms.

Implications for Research: Research is needed to identify the biologic milieu associated with posttraumatic stress and depression in at-risk mothers.

Marcella Niehoff School of Nursing, Loyola University Chicago, Illinois (Dr Garfield); Duke School of Nursing, Durham, North Carolina (Dr Holditch-Davis); Indiana University, Bloomington (Dr Carter); University of Illinois, Chicago (Dr McFarlin); Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor (Dr Seng); The Ohio State University, Columbus (Dr Giurgescu); University of Illinois at Chicago, and Children's Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee (Dr White-Traut).

Correspondence: Lindsey Garfield, PhD, WHNP, Marcella Niehoff School of Nursing, Loyola University Chicago, 2160 S. First Ave, Maywood, IL 60153 (

The work for this article occurred in Chicago, Illinois, at the University of Illinois at Chicago, John H. Stroger Medical Center, and Mount Sinai Medical Center.

This study was supported by National Institutes of Health grants NR 09418 (to Dr Holditch-Davis), NR 010176 (to Dr Garfield). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors declare no conflicts of interest.

© 2019 by The National Association of Neonatal Nurses