Evidence map›Paper›PMID 38724899›Full record

SynthesisBMC pregnancy and childbirth2024

Factors associated with posttraumatic stress and anxiety among the parents of babies admitted to neonatal care: a systematic review.

Reem Malouf, Sian Harrison, Victoria Pilkington, Charles Opondo, Chris Gale, Alan Stein, Linda S Franck, Fiona Alderdice

Abstract readSystematic Review
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Comfort, benefit, and distress: An exploratory study of research experiences of bereaved parents in the neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Reem MaloufNIHR Policy Research Unit in Maternal and Neonatal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health, University of Oxford Old Road Campus Headington, Oxford, OX3 7LF, UK.
Sian HarrisonNIHR Policy Research Unit in Maternal and Neonatal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health, University of Oxford Old Road Campus Headington, Oxford, OX3 7LF, UK.
Victoria PilkingtonNIHR Policy Research Unit in Maternal and Neonatal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health, University of Oxford Old Road Campus Headington, Oxford, OX3 7LF, UK.
Charles OpondoDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
Chris GaleSchool of Public Health, Faculty of Medicine, Neonatal Medicine, Imperial College London, Chelsea and Westminster Campus, 369 Fulham Road, London, SW10 9NH, UK.
Alan SteinDepartment of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK.
Linda S FranckDepartment of Family Health Care Nursing, School of Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA.
Fiona AlderdiceNIHR Policy Research Unit in Maternal and Neonatal Health and Care National Perinatal Epidemiology Unit Nuffield Department of Population Health, University of Oxford Old Road Campus Headington, Oxford, OX3 7LF, UK. fiona.alderdice@npeu.ox.ac.uk.

Funding

National Institute for Health and Care Research (NIHR) Policy Research Programme PR-PRU-1217-21202
6 · The paper itself

Abstract

backgroundPosttraumatic stress (PTS) and anxiety are common mental health problems among parents of babies admitted to a neonatal unit (NNU). This review aimed to identify sociodemographic, pregnancy and birth, and psychological factors associated with PTS and anxiety in this population.

methodStudies published up to December 2022 were retrieved by searching Medline, Embase, PsychoINFO, Cumulative Index to Nursing and Allied Health electronic databases. The modified Newcastle-Ottawa Scale for cohort and cross-sectional studies was used to assess the methodological quality of included studies. This review was pre-registered in PROSPERO (CRD42021270526).

resultsForty-nine studies involving 8,447 parents were included; 18 studies examined factors for PTS, 24 for anxiety and 7 for both. Only one study of anxiety factors was deemed to be of good quality. Studies generally included a small sample size and were methodologically heterogeneous. Pooling of data was not feasible. Previous history of mental health problems (four studies) and parental perception of more severe infant illness (five studies) were associated with increased risk of PTS, and had the strongest evidence. Shorter gestational age (≤ 33 weeks) was associated with an increased risk of anxiety (three studies) and very low birth weight (< 1000g) was associated with an increased risk of both PTS and anxiety (one study). Stress related to the NNU environment was associated with both PTS (one study) and anxiety (two studies), and limited data suggested that early engagement in infant's care (one study), efficient parent-staff communication (one study), adequate social support (two studies) and positive coping mechanisms (one study) may be protective factors for both PTS and anxiety. Perinatal anxiety, depression and PTS were all highly comorbid conditions (as with the general population) and the existence of one mental health condition was a risk factor for others.

conclusionHeterogeneity limits the interpretation of findings. Until clearer evidence is available on which parents are most at risk, good communication with parents and universal screening of PTS and anxiety for all parents whose babies are admitted to NNU is needed to identify those parents who may benefit most from mental health interventions.

Indexed as

AnxietyParentsStress Disorders, Post-TraumaticFemaleHumansInfant, NewbornIntensive Care Units, NeonatalPregnancyRisk FactorsAnxietyFactorsNeonatal unitsPosttraumatic stress disorderPosttraumatic stress symptomsPreterm birthSystematic review

Identifiers

PMID38724899
PMCPMC11084127

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.