129 - Maternal Mental Health, Mother-Infant Engagement, and Neurodevelopment in Preterm Infants

Publication Number: 1119.129

Allison Williams, Children's Hospital of Richmond at VCU, Richmond, VA, United States; Dara Azuma, Children's Hospital of Richmond at VCU, Richmond, VA, United States; Miheret Yitayew, Children's Hospital of Richmond at VCU, Richmond, VA, United States; Nayef Chahin, Children's Hospital of Richmond at VCU, Richmond, VA, United States; Liana Resnikoff, Virginia Commonwealth University School of Medicine, Richmond, VA, United States; Marissa S. Yee, Virginia Commonwealth University School of Medicine, Richmond, VA, United States; Karen D.. Hendricks-Muñoz, Children's Hospital of Richmond at VCU, Richmond, VA, United States

Background: Postpartum mood and anxiety disorders (PMADs) are a leading cause of maternal mortality and the most common birth complication. While PMADs influence infant development, research has largely focused on mothers of healthy, term infants. NICU mothers face higher rates of mental health disorders, and their infants are at greater developmental risk. NICU caregiving is complicated by infants’ medical and sensory needs, which exacerbate maternal stress. Despite these intersecting risks, few studies examine how maternal mental health, caregiving, and infant outcomes interact. We hypothesize that in the NICU, (1) PMADs are prevalent, (2) PMADs are linked to reduced caregiving, and (3) PMADs predicts worse infant neurodevelopment.

Objective: (1) Characterize PMADs and early NICU caregiving. (2) Investigate how PMADs relate to NICU caregiving. (3) Examine how PMADs in the NICU impacts infant neurodevelopment.

Design/Methods: This prospective IRB approved cohort study included inborn infants ( < 37 weeks) or those transferred in the 1st week of life. PMADs and infant engagement were collected via validated self-report measures; infant neurodevelopment was evaluated at 3 months. Descriptive statistics, partial Pearson correlation, and ANCOVA were used for analysis and controlled for infant health severity, at p<.05.

Results: PMADs were prevalent (n = 91) with 19% PTSD, 48% depression, and 76% maternal role-related stress. In first two weeks of admission, 67% of mothers visited > 4 hours a day, 80% participated in rounds, but 56% were not taught containment hold. Earlier and more frequent skin to skin, reading and singing to their infant, containment touch, and changing diapers were associated with better mental health, controlling for infant health. Lactation, attending rounds, and visitation were not associated with better PMADs. Postpartum depression predicted worse neurodevelopment post-discharge, controlling for infant health severity, r = 0.344.

Conclusion(s): This study highlights significant mental health challenges among NICU mothers and the need for proactive, targeted support. Sensory-based interventions were not implemented as early or as often as recommended, suggesting missed opportunities to support both infant and maternal well-being. Active caregiving—rather than passive presence—was associated with improved PMADs.. Maternal depression predicted poorer infant neurodevelopment at follow-up, reinforcing the urgency of addressing PMADs. These findings support standardized NICU practices that promote early, frequent, and developmentally appropriate maternal engagement.