Maternal and neonatal ICU admissions and postpartum outcomes: A cross-sectional observational study on anxiety, depression, and maternal-infant attachment.

PURPOSE: Mother or newborn admission to intensive care units (maternal ICU [MICU] or neonatal ICU [NICU]) is one of the most significant sources of psychological stress during the postpartum period. This cross-sectional observational study aimed to evaluate the effect of intensive care exposure on maternal anxiety, depression, and mother-infant attachment.

METHODS

Mothers were allocated to four groups according to ICU admission: MICU only (n = 28), NICU only (n = 69), combined MICU + NICU (n = 46), and control (n = 64). All assessments were conducted within the first postpartum week, prior to discharge. Psychological health was assessed using the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), and Edinburgh Postnatal Depression Scale (EPDS). Mother-infant attachment was assessed using the Maternal Attachment Inventory (MAI). Group comparisons were performed using the Kruskal-Wallis test.

RESULTS

A total of 207 mothers were included. All ICU-exposed groups had significantly higher anxiety, depression, and postpartum depression scores and significantly lower maternal attachment scores compared with controls (all p < 0.001). In the combined MICU + NICU group, all mothers had high anxiety, most had depression, and the majority met criteria for postpartum depression and scored in the lowest MAI scores. This group also had the lowest breastfeeding rate.

CONCLUSIONS

Maternal or neonatal ICU admission was strongly associated with substantial postpartum psychological morbidity, with an additive effect observed in the combined MICU + NICU group. Maternal critical illness may be associated with disrupted early maternal-infant bonding in addition to the effects of neonatal illness.