Emotional responses of mothers of late-preterm and term infants

Closeness and separation in neonatal intensive care

In this paper, we highlight the need for acknowledging the importance and impact of both physical and emotional closeness between the preterm infant and parent in the neonatal intensive care unit. Physical closeness refers to being spatially close and emotional closeness to parental feelings of being emotionally connected to the infant (experiencing feelings of love, warmth and affection). Through consideration of the literature in this area, we outline some of the reasons why physical closeness and emotional closeness are crucial to the physical, emotional and social well-being of both the infant and the parent. These include positive effects on infant brain development, parent psychological well-being and on the parent–infant relationship. The influence of the neonatal unit environment and culture on physical and emotional closeness is also discussed.

Anxiety among Black and Latina Mothers of Premature Infants at Social-Environmental Risk

Anxiety is heightened for mothers of premature infants, potentially interfering with early mothering. This study describes relationships among race/ethnicity, language, and anxiety for women at social-environmental risk who deliver a premature infant. Postnatal baseline interview data from a randomized trial testing a behavioral intervention for mothers and infants (29-34 weeks gestational age) were used to examine maternal state (STAI-Y1) and trait (STAI-Y2) anxiety among blacks and Latinas, and by language preference. Latinas (n = 97) had an elevated prevalence of high (≥ 40) state anxiety compared to blacks (n = 97), with Latinas preferring a Spanish to an English interview reporting the highest levels of state anxiety. Trait anxiety did not differ across groups. Culturally appropriate interventions are needed to reduce anxiety among Latina mothers delivering premature infants, especially among those with limited English language proficiency. A racially/ethnically diverse workforce, bilingual healthcare providers, and trained medical interpreters may help to ensure better outcomes.

Newborn clinical outcomes of the AWHONN late preterm infant research-based practice project

OBJECTIVE

To describe the neonatal health risks (hypothermia, hypoglycemia, hyperbilirubinemia, respiratory distress, the need for a septic workup, and feeding difficulties) experienced by late preterm infants (LPIs) from a large multisite study and determine how these risks were affected by gestational age at birth.

DESIGN

Descriptive analysis of prospective data obtained as part of the AWHONN Late Preterm Infant Research-Based Practice Project.

SETTING

Fourteen hospitals located through the United States and Canada.

PARTICIPANTS

Late preterm infants (802) born at gestational ages between 34 0/7 and 36 6/7 weeks.

METHODS

Nurses at each site obtained consent from the mother of the infant. The data about the infant were gathered from the infant's medical record.

RESULTS

Thirty-six percent of LPIs were initially cared for in a special care nursery; approximately one half of these infants were eventually transferred to a well-baby nursery. Of the 64% of LPIs initially cared for in a routine nursery, 10% were transferred to a special care unit or neonatal intensive care unit (NICU). More than one half of LPIs experienced hypothermia, hypoglycemia, feeding difficulties, hyperbilirubinemia, and respiratory distress and/or needed a septic workup. The risk for these problems was higher in infants of younger gestational ages. Thirty-two percent of the infants were bathed during the first 2 hours of life, and by 4 hours, more than two thirds had had their first bath. Fifty-two percent received kangaroo care during the first 48 hours of life.

CONCLUSION

These findings support those of smaller studies indicating that LPIs are at high risk for developing health problems during their neonatal hospitalization. Nurses may be able to ameliorate some of these health problems through early identification of problems and simple, inexpensive interventions such as avoiding early bathing and promoting kangaroo care.