Asst Prof University of Alabama School of Medicine Birmingham, Alabama, United States
Background: Infants admitted to the NICU are at increased risk for neurodevelopmental impairment due to their prematurity or illness. Increased exposure to reading aloud beginning in early infancy may help mitigate these deficits. Recent studies have shown that reading interventions in the NICU can promote shared reading at home. However, there have been barriers to sustaining such programs over the long term. Objective: To identify parental barriers - impaired bonding, stress, and depression to reading aloud in the NICU. Design/Methods: Parents of preterm infants ( < 32 weeks) admitted to a level 4 NICU between Feb, 23 to Sep, 23 were administered validated questionnaires within 2 weeks of admission to the NICU. These questionnaires included (i) StimQ-I READ subscale to assess reading environment and shared reading practices, (ii) Mother-Infant bonding, (iii) Edinburgh Postpartum Depression (iv) Spielberger State-Trait Anxiety Inventory. The frequency of reading was assessed by a 4-point Likert scale from “never” to “most days.” Spearman correlation analysis was done to measure the strength of the association between variables of interest. Results: The study population comprised 77 infants with an average gestational age of 26.9 ± 3 weeks, 48% were males, and 65% were on Medicaid. There was no correlation between Mother-Infant bonding scores (n=43) and reading frequency (p=0.99), and this questionnaire was replaced with the stress and depression questionnaire (n=34). Parents with high-stress scores were less likely to read to their infants (r= -0.52, p=0.03). No correlation between depression score and reading frequency was seen (r= -0.38, p=0.13). Interestingly, parents with high-stress scores (r=0.51, p=0.04) and high depression scores (r=0.61, p< 0.001) were less likely to be advised by the healthcare staff to read to their infant. Parents who were shown by the healthcare staff how to read to their infant in the NICU said they were more likely to read to their baby at home (r=0.41, p< 0.001) and wanted to visit more frequently and spend more time with their baby in the NICU (r=0.28, p=0.01).
Conclusion(s): Parental depression and stress are significant barriers to reading aloud in the NICU among very preterm infants. Highly stressed or depressed parents are less likely to receive advice on the benefits of reading aloud in the NICU. Healthcare staff play an important role in advocating for shared reading leading to increased reading behavior and frequency of visits. Our ongoing study is targeting to improve reading aloud frequency in these high-risk parents.
