Frequency of Acute Stress Disorder (ASD) and Postnatal Depression in Mothers Of Preterm Neonates Hospitalized in a Neonatal Intensive Care Unit (NICU) in Pakistan

Abstract

Objective: To determine the frequency of Acute Stress Disorder (ASD) and postnatal depression in mothers of preterm neonates hospitalized in the neonatal intensive care unit (NICU) of the Aga Khan University Hospital. Methodology: It is a cross-sectional study. It was conducted in a 24-bed level-3 NICU at a tertiary care hospital in Karachi. Mothers of preterm newborns under 34 weeks’ gestational age admitted to the NICU were included in the study. Results: Among 123 postpartum women, 43.1% (n=53) met criteria for Acute Stress Disorder (ASD), with significantly lower gestational age in this group: median 29.9 weeks (IQR: 27.6-31.0) vs. 33.0 weeks (IQR: 32.0-33.0) in non-ASD cases (difference in medians: 3.1 weeks, 95% CI: 2.1-4.0). Infants of mothers with ASD had a less mean birth weight (1.3 ± 0.4 kg) compared to those without ASD (1.8 ± 0.5 kg), with a mean difference of 0.5 kg (95% CI: 0.34-0.66). Median NICU stay was significantly prolonged in the ASD group: 20.0 days (IQR: 12.0-28.0) versus 10.0 days (IQR: 7.0-15.0), with an estimated median difference of 10.0 days (95% CI: 6.0-14.0). A higher number of mothers with a miscarriage history (n=23/53, 43.4%) experienced ASD compared to those without (n=17/70, 24.3%), yielding a risk difference of 19.1% (95% CI: 4.3%-33.8%). Mothers with ASD also reported increased Edinburgh Postnatal Depression Scale scores (median 19.0, IQR: 17.0-21.0) than those without ASD (median 11.0, IQR: 9.0-15.0), with a median difference of 8.0 points (95% CI: 6.0-10.0). Conclusion: A significant proportion of mothers of preterm infants screened positive for acute stress disorder and postpartum depression hence, Preterm delivery appears to be a traumatic event, increasing the risk of stress-related and depressive disorders in mothers.