WIP 78 - Associations between NICU stay and postpartum maternal mental health with parenting behaviors

Poster Number: WIP 78
Publication Number: WIP 78.739

Background: Mothers of infants in the neonatal intensive care unit (NICU) are at increased risk for postpartum depression, anxiety, and post-traumatic stress disorder. These, in turn, may contribute to unhealthy parenting behaviors. Given substantial evidence that exposure to unhealthy discipline increases the risk of poor mental and physical health outcomes in children, routine screening for parenting behaviors is recommended. The Quick Parenting Assessment (QPA) is a brief tool that assesses healthy and unhealthy parenting behaviors in children 1-10 years. In a prior cross-sectional study, QPA scores >4 were associated with nine times the odds of the child having concurrent behavior problems compared with QPA scores of 0-2 (OR 8.93, 95%CI 3.74-21.32). An association between maternal mental health in the neonatal period and later QPA score would suggest that routine screening for maternal mental health in the NICU provides an opportunity to intervene to improve parenting behaviors and ultimately child health outcomes.

Objective: The objective of this study is to describe the relationships between infant NICU stay and maternal postpartum depression symptoms with subsequent parenting behaviors as measured via QPA at well-child visits.

Design/Methods: This study was approved by the Vanderbilt IRB. The exposures to be assessed are: 1) infant NICU stay and 2) maternal postpartum depression score as measured by the Edinburgh Postnatal Depression Scale (EPDS) collected retrospectively via chart review. The outcome to be assessed is unhealthy parenting behaviors as measured by QPA scores collected prospectively in a prior cohort study. We plan to perform multinomial logistic regression to evaluate the associations between infant NICU stay (dichotomous, yes/no) and maternal postpartum depression symptoms (continuous, 0-30) with downstream QPA score (categorical, 0-2, 3-4, or >4). We will adjust for child age, race/ethnicity, caregiver education, household income, and preexisting maternal mental health diagnosis. Data analysis will be completed by 3/01/24.