Macro preemies: no thresholds for risks or concerns

Prevalence and Longevity of PTSD Symptoms Among Parents of NICU Infants Analyzed Across Gestational Age Categories

Objective. This study aims to investigate whether posttraumatic stress disorder (PTSD) symptoms exist >1 year after neonatal intensive care unit (NICU) experience and whether PTSD symptomatology differs across parents of infants of different gestational age categories. Methods. A survey was given to parents at routine NICU follow-up visits. Parents completed the PTSD CheckList-Civilian (PCL-C), a standardized scale comprising 17 key symptoms of PTSD. Parents also rated how traumatic their birth experience, first day in the NICU, and first week in the NICU were from "Not Traumatic at All" to "Most Traumatic." Fisher's exact test was used to compare PCL-C responses across gestational age categories (Extremely Preterm, Very Preterm, Moderate to Late preterm, and Full Term). Results. Eighty parents participated. In total, 15% of parents had "Moderate to High Severity" PTSD symptoms. There were no statistical differences in PTSD prevalence between parents of children <1 year old and parents of children >1 year old (P = .51). There was also no statistical difference in prevalence of "Moderate to High Severity" level of PTSD symptoms across gestational age (P = .16). Overall, 38% of parents rated at least one experience as "Most traumatic." Conclusion. A high percentage of parents who had a recent NICU experience and parents who had a NICU experience more than a year ago demonstrated PTSD symptoms. In light of these results, many parents of NICU graduates-both mothers and fathers-would benefit from access to long-term counseling services.

Parental Perception of Risk Associated With Their Premature Infant

BACKGROUND

Preterm birth has been linked to increased parental stress, depression, and anxiety. Although the rate of neonatal morbidity and mortality decreases with increasing gestational age, recent research has revealed that there is no threshold age for risk or parental concern.

PURPOSE

This study examines parental concern about medical and developmental outcomes of their premature infant.

METHODS

Parents of 60 premature infants were surveyed in a follow-up clinic regarding their level of concern about 11 morbidities and their child's gestation-adjusted age; these were compared with the infant's inpatient chart. "Concern scores" were tallied and compared across gestational age groups and knowledge of gestation-adjusted age using Chi-square tests of independence.

FINDINGS

Many parents reported concerns about morbidities that were unsupported by their child's diagnoses. Across parents of extremely, very, and moderate-late preterm children, the mean concern scores were 13.9, 15.7, and 19.7, respectively. Overall, 62% of parents incorrectly reported the gestation-adjusted age of their child. Parents who were correct were significantly more likely to correctly anticipate abnormal developmental patterns (70%) and growth patterns (65%) than those who were incorrect (33% and 31%, respectively).

IMPLICATIONS FOR RESEARCH

Future research should focus on whether NICU graduate parental stress levels are directly linked to the severity of their child's condition, and how physicians can help decrease NICU graduate parental stress.

IMPLICATIONS FOR PRACTICE

Parental anxiety regarding all gestational age neonatal intensive care unit infant outcomes can be decreased by a thorough explanation of gestation-adjusted age and a discussion of expected prematurity-related issues.