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Acute Posttraumatic Stress Symptoms Among Urban Mothers With Newborns in the Neonatal Intensive Care Unit: A Preliminary Study

Vanderbilt, Douglas MD*; Bushley, Traute RN, MPH; Young, Robin MA; Frank, Deborah A. MD

Journal of Developmental & Behavioral Pediatrics: February 2009 - Volume 30 - Issue 1 - p 50-56
doi: 10.1097/DBP.0b013e318196b0de
Original Article

Objectives: Traumatic stress symptoms from multiple causes are endemic among impoverished women who are also at high risk for delivering infants requiring neonatal intensive care unit (NICU) care, but whether this event itself constitutes a distinct traumatic stress trigger is unknown. Previous research does suggest having an infant in the NICU generates traumatic stress among white middle-class mothers, stress that can impact their infant’s behavior and development. This study evaluated the prevalence of acute posttraumatic stress symptoms among low-income mothers of infants admitted to the NICU compared with similar mothers with infants in the well baby nursery (WBN).

Methods: A total of 59 NICU and 60 WBN mothers were recruited from the Boston Medical Center. Within the first week after birth, all participants were assessed for postpartum acute posttraumatic stress and depression symptoms and asked about lifetime traumatic events before the birth of their baby. The acute posttraumatic stress symptoms were analyzed as a continuous variable and whether they reached the categorical severity criteria for acute stress disorder.

Results: NICU mothers show increased symptoms of acute posttraumatic stress and depression. Twenty-three percent of NICU and 3% of WBN reached severity criteria for acute stress disorder. When controlling for relevant covariates, having a newborn in the NICU had a significant association with the number of mothers’ acute posttraumatic stress symptoms not fully explained by their symptoms of depression or prior lifetime history of traumatic events.

Conclusions: Addressing acute posttraumatic stress symptoms may enhance interventions to help urban families of NICU infants.

From the *Division of General Pediatrics, Keck School of Medicine, Childrens Hospital Los Angeles, Los Angeles, CA; †Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA; and ‡Data Coordinating Center, Boston University School of Public Health, Boston, MA.

Received May 2008; accepted October 2008.

Address for reprints: Douglas Vanderbilt, M.D., Division of General Pediatrics, Childrens Hospital Los Angeles, Keck School of Medicine at the University of Southern California, 4650 Sunset Blvd. #76, Los Angeles, CA 90027; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.