Prevention of traumatic stress in mothers of preterms: 6-month outcomes

• Published in: Pediatrics (Evanston) Vol. 134; no. 2; p. e481
• Main Authors: Shaw, Richard J, St John, Nick, Lilo, Emily, Jo, Booil, Benitz, William, Stevenson, David K, Horwitz, Sarah M
• Format: Journal Article
• Language: English
• Published: United States 01.08.2014
• Subjects: Anxiety - prevention & control; Cognitive Therapy; Depression - prevention & control; Female; Humans; Infant, Premature - psychology; Mothers - psychology; Stress, Psychological - prevention & control; Treatment Outcome; PTSD; premature infants; neonatal ICU; preterm infants; intervention; neonatal intensive care; posttraumatic stress disorder
• ISSN: 1098-4275
• DOI: 10.1542/peds.2014-0529

Symptoms of posttraumatic stress disorder are a well-recognized phenomenon in mothers of preterm infants, with implications for maternal health and infant outcomes. This randomized controlled trial evaluated 6-month outcomes from a skills-based intervention developed to reduce symptoms of posttraumatic stress disorder, anxiety, and depression. One hundred five mothers of preterm infants were randomly assigned to (1) a 6- or 9-session intervention based on principles of trauma-focused cognitive behavior therapy with infant redefinition or (2) a 1-session active comparison intervention based on education about the NICU and parenting of the premature infant. Outcome measures included the Davidson Trauma Scale, the Beck Depression Inventory II, and the Beck Anxiety Inventory. Participants were assessed at baseline, 4 to 5 weeks after birth, and 6 months after the birth of the infant. At the 6-month assessment, the differences between the intervention and comparison condition were all significant and sizable and became more pronounced when compared with the 4- to 5-week outcomes: Davidson Trauma Scale (Cohen's d = -0.74, P < .001), Beck Anxiety Inventory (Cohen's d = -0.627, P = .001), Beck Depression Inventory II (Cohen's d = -0.638, P = .002). However, there were no differences in the effect sizes between the 6- and 9-session interventions. A brief 6-session intervention based on principles of trauma-focused cognitive behavior therapy was effective at reducing symptoms of trauma, anxiety, and depression in mothers of preterm infants. Mothers showed increased benefits at the 6-month follow-up, suggesting that they continue to make use of techniques acquired during the intervention phase.