Am J Perinatol 2016; 33(08): 770-775
DOI: 10.1055/s-0036-1572543
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Seeing Their Children in Pain: Symptoms of Posttraumatic Stress Disorder in Mothers of Children with an Anomaly Requiring Surgery at Birth

Lucia Aite
1   Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
,
Francesca Bevilacqua
1   Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
,
Antonio Zaccara
2   Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy
,
Edoardo La Sala
3   Centro dati, Fondazione GINEMA, Rome, Italy
,
Simonetta Gentile
1   Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
,
Pietro Bagolan
4   Department of Neonatal Medicine and Surgery, Bambino Gesù Children's Hospital, Rome, Italy
› Author Affiliations
Further Information

Publication History

07 August 2015

29 December 2015

Publication Date:
18 February 2016 (online)

Abstract

Objective Assess the presence of posttraumatic stress disorder (PTSD) symptoms in mothers of newborns requiring early surgery.

Study Design Mothers of newborns operated on for a congenital anomaly underwent a semi-structured interview on their experience 6 months postpartum. Interviews were audiotaped, transcribed verbatim, and analyzed for symptoms of the three major criteria of PTSD: re-experiencing, avoidance, and heightened arousal.

Results A total of 120 mothers took part in the study; their children were affected by one of the following congenital anomaly: esophageal atresia (n = 29); congenital diaphragmatic hernia (n = 38); midgut malformations (n = 38); and abdominal wall defects (n = 15). Two mothers did not show any symptoms; 12 mothers (10%) had one posttraumatic symptom, 77 (64.2%) had two, and 29 (24.2%) had three. Overall, 106 mothers (88.4%) presented at least two symptoms.

Conclusion PTSD can be considered a useful model to describe and comprehend mothers' reactions in this specific population. Preventive interventions and dedicated follow-up program should be offered to these families.

 
  • References

  • 1 American Psychiatric Association. Manuale Diagnostico e Statistico dei Disturbi Mentali. 5th ed. Milano: Raffaello Cortina Editore; 2014
  • 2 Van der Kolk BA, McFarlane AC, Weisaeth L. Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society. New York, NY: Guilford Press; 2006: 136
  • 3 Franck LS, Wray J, Gay C, Dearmun AK, Lee K, Cooper BA. Predictors of parent post-traumatic stress symptoms after child hospitalization on general pediatric wards: a prospective cohort study. Int J Nurs Stud 2015; 52 (1) 10-21
  • 4 Feeley N, Zelkowitz P, Cormier C, Charbonneau L, Lacroix A, Papageorgiou A. Posttraumatic stress among mothers of very low birthweight infants at 6 months after discharge from the neonatal intensive care unit. Appl Nurs Res 2011; 24 (2) 114-117
  • 5 Holditch-Davis D, Bartlett TR, Blickman AL, Miles MS. Posttraumatic stress symptoms in mothers of premature infants. J Obstet Gynecol Neonatal Nurs 2003; 32 (2) 161-171
  • 6 Stuber ML, Kazak AE, Meeske K, Barakat L. Is posttraumatic stress a viable model for understanding responses to childhood cancer?. Child Adolesc Psychiatr Clin N Am 1998; 7 (1) 169-182
  • 7 Barakat LP, Kazak AE, Meadows AT, Casey R, Meeske K, Stuber ML. Families surviving childhood cancer: a comparison of posttraumatic stress symptoms with families of healthy children. J Pediatr Psychol 1997; 22 (6) 843-859
  • 8 de Vries AP, Kassam-Adams N, Cnaan A, Sherman-Slate E, Gallagher PR, Winston FK. Looking beyond the physical injury: posttraumatic stress disorder in children and parents after pediatric traffic injury. Pediatrics 1999; 104 (6) 1293-1299
  • 9 Franich-Ray C, Bright MA, Anderson V , et al. Trauma reactions in mothers and fathers after their infant's cardiac surgery. J Pediatr Psychol 2013; 38 (5) 494-505
  • 10 Chemtob CM, Gudiño OG, Laraque D. Maternal posttraumatic stress disorder and depression in pediatric primary care: association with child maltreatment and frequency of child exposure to traumatic events. JAMA Pediatr 2013; 167 (11) 1011-1018
  • 11 Aite L, Zaccara A, Mirante N , et al. Antenatal diagnosis of congenital anomaly: a really traumatic experience?. J Perinatol 2011; 31 (12) 760-763
  • 12 Aite L, Zaccara A, Nahom A, Trucchi A, Iacobelli B, Bagolan P. Mothers' adaptation to antenatal diagnosis of surgically correctable anomalies. Early Hum Dev 2006; 82 (10) 649-653
  • 13 Busse M, Stromgren K, Thorngate L, Thomas KA. Parents' responses to stress in the neonatal intensive care unit. Crit Care Nurse 2013; 33 (4) 52-59 , quiz 60
  • 14 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994
  • 15 Sandelowski M. Qualitative analysis: what it is and how to begin. Res Nurs Health 1995; 18 (4) 371-375
  • 16 Sandelowski M, Jones LC. Healing fictions': stories of choosing in the aftermath of the detection of fetal anomalies. Soc Sci Med 1996; 42 (3) 353-361
  • 17 Laing S, McMahon C, Ungerer J, Taylor A, Badawi N, Spence K. Mother-child interaction and child developmental capacities in toddlers with major birth defects requiring newborn surgery. Early Hum Dev 2010; 86 (12) 793-800
  • 18 Muller-Nix C, Forcada-Guex M, Pierrehumbert B, Jaunin L, Borghini A, Ansermet F. Prematurity, maternal stress and mother-child interactions. Early Hum Dev 2004; 79 (2) 145-158
  • 19 Forcada-Guex M, Borghini A, Pierrehumbert B, Ansermet F, Muller-Nix C. Prematurity, maternal posttraumatic stress and consequences on the mother-infant relationship. Early Hum Dev 2011; 87 (1) 21-26
  • 20 Kazak AE, Alderfer M, Rourke MT, Simms S, Streisand R, Grossman JR. Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in families of adolescent childhood cancer survivors. J Pediatr Psychol 2004; 29 (3) 211-219
  • 21 Green M, Solnit AJ. Reactions to the threatened loss of a child: a vulnerable child syndrome. Pediatric management of the dying child, part III. Pediatrics 1964; 34: 58-66
  • 22 Kaitz M, Maytal HR, Devor N, Bergman L, Mankuta D. Maternal anxiety, mother-infant interactions, and infants' response to challenge. Infant Behav Dev 2010; 33 (2) 136-148
  • 23 Manne S, DuHamel K, Nereo N , et al. Predictors of PTSD in mothers of children undergoing bone marrow transplantation: the role of cognitive and social processes. J Pediatr Psychol 2002; 27 (7) 607-617
  • 24 De Ocampo AC, Macias MM, Saylor CF, Katikaneni LD. Caretaker perception of child vulnerability predicts behavior problems in NICU graduates. Child Psychiatry Hum Dev 2003; 34 (2) 83-96
  • 25 Balluffi A, Kassam-Adams N, Kazak A, Tucker M, Dominguez T, Helfaer M. Traumatic stress in parents of children admitted to the pediatric intensive care unit. Pediatr Crit Care Med 2004; 5 (6) 547-553
  • 26 Bronner MB, Peek N, Knoester H, Bos AP, Last BF, Grootenhuis MA. Course and predictors of posttraumatic stress disorder in parents after pediatric intensive care treatment of their child. J Pediatr Psychol 2010; 35 (9) 966-974
  • 27 Colville GA, Gracey D. Mothers' recollections of the Paediatric Intensive Care Unit: associations with psychopathology and views on follow up. Intensive Crit Care Nurs 2006; 22 (1) 49-55
  • 28 Winston FK, Kassam-Adams N, Vivarelli-O'Neill C , et al. Acute stress disorder symptoms in children and their parents after pediatric traffic injury. Pediatrics 2002; 109 (6) e90
  • 29 Lefkowitz DS, Baxt C, Evans JR. Prevalence and correlates of posttraumatic stress and postpartum depression in parents of infants in the Neonatal Intensive Care Unit (NICU). J Clin Psychol Med Settings 2010; 17 (3) 230-237
  • 30 Pierrehumbert B, Nicole A, Muller-Nix C, Forcada-Guex M, Ansermet F. Parental post-traumatic reactions after premature birth: implications for sleeping and eating problems in the infant. Arch Dis Child Fetal Neonatal Ed 2003; 88 (5) F400-F404
  • 31 Jotzo M, Poets CF. Helping parents cope with the trauma of premature birth: an evaluation of a trauma-preventive psychological intervention. Pediatrics 2005; 115 (4) 915-919
  • 32 Borghini A, Habersaat S, Forcada-Guex M , et al. Effects of an early intervention on maternal post-traumatic stress symptoms and the quality of mother-infant interaction: the case of preterm birth. Infant Behav Dev 2014; 37 (4) 624-631