Abstract
Objective The objective of this paper was to assess how hospital and outpatient clinic policies
changes due to the coronavirus disease 2019 (COVID-19) pandemic impact pediatric medical
traumatic stress (PMTS) symptoms in mothers of newborns admitted in a neonatal intensive
care unit (NICU).
Study Design Observational case-control study included the comparison between mothers of infants
admitted in the NICU at birth during the COVID-19 pandemic and mothers of infants
admitted in the NICU before the COVID-19 pandemic. The control group was selected
matching 1:1 with the study group for the following infants' clinical variables: gender,
type of pathology, gestational age, weight at birth, day of recovery, ventilator time
days, and associated malformations. The Italian version of the Impact of Event Scale—Revised
(IES-R) was used as a measure of PMTS.
Result Mothers of the study group (50) scored significantly higher than mothers of the control
group on three of four scales of IES-R (“IES-R total”: F = 6.70; p = 0.011; IES-R subscale “intrusion”: F = 7.45; p = 0.008; IES-R subscale “avoidance”: F = 8.15; p = 0.005). A significantly higher number of mothers in the study group scored above
the IES-R total clinical cut-off compared with mothers of control group (72 vs. 48%;
Chi2 = 6.00; p = 0.012).
Conclusion The COVID-19 pandemic acted as superimposed stress in mothers of newborns admitted
in the NICU at birth determining high levels of PMTS. Clinicians and researchers should
identify and implement novel strategies to provide family-centered care during the
COVID-19 pandemic and beyond.
Key Points
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COVID-19 acted as superimposed stress on NICU population.
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PMTS in mothers got significantly worse during the COVID-19 pandemic.
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Alert on long-term consequences on child development.
Keywords
pediatric medical traumatic stress - NICU - COVID-19 - maternal psychological distress
