Alarming rates of depression for parents of babies born before 30 weeks
A study that will be published in JAMA Pediatrics showed that more than one in five parents of infants born very preterm still show symptoms of depression and anxiety six months after birth.
Another important finding of this Melbourne-based study was that fathers of infants born very preterm had rates of depression and anxiety comparable with mothers. This was a surprising finding, as males in the general population, whether or not they are fathers, tend to have far lower rates of depression and anxiety.
Led by Dr Carmen Pace, researchers followed 113 mothers and 101 fathers of very preterm babies born at the Royal Women's Hospital, Melbourne.
Parents' symptoms of depression and anxiety were documented every two weeks until the infant's expected birth date, and again at six months postpartum. This is the most detailed examination of depression and anxiety in parents of very preterm infants during the newborn period.
Researchers used standardised screening tools to assess symptoms of depression and anxiety.
Dr Pace said mothers and fathers of very preterm infants had concerning rates of depression and anxiety symptoms in the weeks following birth.
"While the rates of depression and anxiety declined with time, they remained well above expected levels throughout the newborn period and at six months, never dropping below 20 per cent."
There was little evidence that mothers and fathers psychological distress was related to medical severity, time of discharge, transfer to other hospitals, or other family factors.
Radford and Kirsten White are parents to twins Rupert and Maisie who were born at 29 weeks and six days' gestation after scans revealed that Rupert was not receiving sufficient blood through the placenta, requiring an early delivery on July 19 to save his life.
The experience has been an emotional rollercoaster for both Kirsten and Radford.
Radford explains, "No one plans for a premature baby. And all the plans you had made are now thrown out the window with the premature birth. The reality of a NICU admission created an overwhelming sense of helplessness for both Kirsten and myself.
How do you announce that the babies everyone knows about in utero have arrived, but have no idea if they will survive to see their grandmother, auntie, cousins or even their mum? It was gut wrenching and I'm not sure we will ever get over that."
Compared with parents of full-term infants (born after 37 weeks' gestation), parents of very preterm infants had far higher rates of depression:
Shortly after birth:
- mothers: 40 per cent (very preterm babies) vs 6 per cent (full term babies)
- fathers: 36 per cent vs 5 per cent
And at six months
- mothers: 14 per cent vs 5 per cent
- fathers: 19 per cent vs 6 per cent
Parents of very preterm infants had far higher rates of anxiety:
Shortly after birth:
- mothers: 48 per cent vs 13 per cent
- fathers: 47 per cent vs 10 per cent
And at six months:
- mothers: 25 per cent vs 14 per cent
- fathers: 20 per cent vs 10 per cent
"Understanding mental health in parents of very preterm infants is critical as parental depression and anxiety may be persistent, and adversely impact parenting, and ultimately child development," said Dr Pace. "Children born preterm are already at risk of other developmental and health issues."
"The findings demonstrate that we need to be conscious of fathers' wellbeing too. Most dads remain involved in the day-to-day care of their infants while they are in hospital, and often juggle this with returning to work."