AUTHOR=Bua Jenny , Mariani Ilaria , Girardelli Martina , Tomadin Murphy , Tripani Antonella , Travan Laura , Lazzerini Marzia 

TITLE=Parental Stress, Depression, and Participation in Care Before and During the COVID-19 Pandemic: A Prospective Observational Study in an Italian Neonatal Intensive Care Unit

JOURNAL=Frontiers in Pediatrics

VOLUME=9

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.737089

DOI=10.3389/fped.2021.737089

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> Recent studies reported, during the COVID-19 pandemic, increased mental distress among the general population and among women around the childbirth period. COVID-19 pandemic may undermine the vulnerable well-being of parents in Neonatal Intensive Care Units (NICUs).</p><p><bold>Objective:</bold> Our study aimed to explore whether parental stress, depression, and participation in care in an Italian NICU changed significantly over three periods: pre-pandemic (T<sub>0</sub>), low (T<sub>1</sub>), and high COVID-19 incidence (T<sub>2</sub>).</p><p><bold>Methods:</bold> Enrolled parents were assessed with the Parental Stressor Scale in the NICU (PSS:NICU), Edinburgh Postnatal Depression Scale (EPDS), and Index of Parental Participation (IPP). Stress was the study primary outcome. A sample of 108 parents, 34 for each time period, was estimated to be adequate to detect a difference in PSS:NICU stress occurrence level score (SOL) of 1.25 points between time periods. To estimate score differences among the three study periods a non-parametric analysis was performed. Correlation among scores was assessed with Spearman rank coefficient.</p><p><bold>Results:</bold> Overall, 152 parents were included in the study (62 in T<sub>0</sub>, 56 in T<sub>1</sub>, and 34 in T<sub>2</sub>). No significant differences in the median PSS:NICU, EPDS, and IPP scores were observed over the three periods, except for a slight increase in the PSS:NICU parental role sub-score in T<sub>2</sub> (T<sub>0</sub> 3.3 [2.3–4.1] vs. T<sub>2</sub> 3.9 [3.1–4.3]; <italic>p</italic> = 0.038). In particular, the question regarding the separation from the infant resulted the most stressful aspect during T<sub>2</sub> (T<sub>0</sub> 4.0 [4.0–5.0] vs. T<sub>2</sub> 5.0 [4.0–5.0], <italic>p</italic> = 0.008). The correlation between participation and stress scores (<italic>r</italic> = 0.19–022), and between participation and depression scores (<italic>r</italic> = 0.27) were weak, while among depression and stress, a moderate positive correlation was found (<italic>r</italic> = 0.45–0.48).</p><p><bold>Conclusions:</bold> This study suggests that parental stress and depression may be contained during the COVID-19 pandemic, while participation may be ensured.</p>