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Traumatic Stress and Mothers of Preterm Infants – A Study about Prevention

An Article Fairy Summary by Laura Madlinger-Lewis

When we hear the term “posttraumatic stress disorder”, we often think of those who have defended our country in war or someone who has witnessed a terrible crime, and not necessarily parents of infants in the NICU.

However, there is a large body of evidence which demonstrates that parents of preterm and sick infants can experience symptoms of posttraumatic stress disorder (PTSD) during their child’s hospital stay and even long after.


This negatively impacts the parent-child relationship and overall quality of life.

As neonatal therapists, we have all probably worked with parents who experience PTSD symptoms such as

  • avoidance (not visiting their infant despite having the means to come to the hospital)
  • physiological reactivity (racing heart when entering the unit)
  • or blaming themselves for what has happened.

Although supportive therapy is available, NICU parents face a unique set of emotional challenges. What if there was a program designed specifically to reduce parental trauma and depression for parents of babies in the NICU?

Researchers at Stanford University School of Medicine and New York University Medical School sought to evaluate the effectiveness of an intervention developed specifically to target parental trauma and infant redefinition versus an active comparison group in reducing symptoms of post-traumatic stress, anxiety, and depression in mothers of preterm infants. Participants in the intervention group received six sessions of treatment consisting of psychoeducation, cognitive restructuring, progressive muscle relaxation, and development of their trauma narrative.

The treatment was provided by therapists who adhered precisely to the written treatment manual. The study, published last fall in the journal Pediatrics, found that mothers in the intervention group reported a significantly greater reduction in trauma symptoms and depression, and that mothers in both groups had significant improvement in anxiety.

The findings of this study are important to neonatal therapists for several reasons.

  • We can convey to parents who are struggling with PTSD that they are not alone in what they are experiencing, and that treatment specific to parents of NICU babies is available and effective.
  • The authors of the study highlight that this intervention is based on a written manual, and can be taught to individuals who do not have any specific training in psychological treatments.
  • In many NICUs neonatal therapists help facilitate parent support groups, and this intervention could be something to consider including in these groups if deemed appropriate.

Below is a link to the abstract for the above study, as well as information for accessing the full text article.
Shaw, R., St John, N., Lilo, E., Jo, B., Benitz, W., Stevenson, D., & Horwtiz, S. (2013). Prevention of traumatic stress in mothers with preterm infants: A randomized controlled trial. Pediatrics, 132, e886-e894.