Abstract
Disruption of maternal-infant bonding, hospital environments, and appearance of an unwell child are common triggers of maternal stress in Neonatal Intensive Care Units (NICUs) in high-income countries. Characterizations of maternal stress in low-income countries are lacking, and may differ due to scarcity of healthcare workers and resources. Therefore, we aimed to evaluate maternal stress and contributing factors in a Ugandan neonatal hospital unit.
The study was conducted at Jinja Regional Referral Hospital with fifty mother-baby dyads. Demographic data was collected by surveys and stress was evaluated with the Parental Stressor Scale: NICU (PSS:NICU). Factors associated with PSS:NICU scores were determined by hierarchical linear regression.
Thirty-five mothers (70%) received secondary (or higher) education, and 22 (44%) were first-time mothers. Asphyxia was the most frequent (n=31, 62%) hospitalization reason, and median length of stay was six days (IQR: 5-7 days). The mean maternal stress level on the PSS:NICU was 3.47±0.84, with the highest scores in Baby Appearance and Behaviour (3.86±0.51). Mothers of asphyxiated infants and older mothers with higher education had elevated Sights and Sounds scores. Female infants at older gestational age were associated with lower Parental Role Alteration scores.
The mean PSS:NICU score of 3.47 out of 5 represents high maternal stress, comparable to high-income countries. Interventions that reduce maternal stress in high-income countries may be effective for Ugandan mothers. Efforts should begin at admission as median stay is under a week and should include maternal education about baby appearance as the highest stress score category was Baby Appearance and Behaviour.
