Stress beyond the Neonatal Intensive Care Unit (NICU) Discharge: Implications to Outcome

Abstract

Purpose: The high-risk parental experience in the neonatal intensive care environment is a major
stress event that is not necessarily resolved with discharge. Many parents report “walking
on eggshells” with worry and stress for up to a year beyond the birth of their infant. Because
stressors can induce behavioral, physiological, and biochemical changes to such a degree that
family adaptation is challenged, attempting to resolve stressors before the discharge should be
a goal. The ethical concept of beneficence (doing good) provides the Neonatal Intensive Care
Unit (NICU) nurse with a framework for wanting to lower stressors as much as possible prior
to discharge. The purpose of this study was to examine the relationship between high-risk
experiences including high-risk pregnancies, deliveries, and NICU admissions and unresolved
parental stress up to a year after delivery.
Method: Women in a day care center with infants under a year old were tested for their emotional
status and pregnancy related demographics.
Principal Results: Findings show a positive correlation between two factors, both NICU admission
of a newborn and parental stress (r=.88) and a high risk primiparous births without NICU
admissions and parental stress (r=.72).
Major Conclusion: While this is a pilot study, the findings illustrate unresolved parental stress
well beyond the birth of the baby, providing ethical support for early identification of stressed
parents and interventions to normalize that stress before discharge. When parents report significant
stress after their deliveries or infants’ NICU admissions, and there is no specific intervention
to identify and reduce this stress, high levels of stress may last and be measurable even a
year later.

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