Next Newborn / Neonatal Initiative

General Meeting
March 1, 2016

Support for NICU Parents
Alison Stuebe, MD, MSc, FACOG

Initiative Background
• The NICU experience is a potentially traumatic
– 9 to 53% of mothers score above threshold on PTSD
– 39-63% of NICU mothers report elevated symptoms of
depression in the first postpartum year
– Fathers are also at increased risk of depression and

• Parental depression and anxiety are associated
with adverse infant developmental outcomes

Initiative Background

Profit et al (2014).
"Burnout in the NICU
setting and its relation
to safety culture." BMJ
Quality & Safety.

Initiative Background

Profit et al (2014)
BMJ Quality & Safety.

"In the ideal NICU, psychosocial support of both
NICU parents and staff should be goals equal in
importance to the health and development of
Hynan MT & Hall SL. "Introduction: Psychosocial Program
Standards for NICU Parents." J Perinatol Supplement Dec. 2015.

Initiative Background

Initiative Aim
Goal: Improve psychosocial support at each center
by implementing elements of the National Perinatal
Association’s Interdisciplinary Recommendations.
Key Outcome Measure(s):
• Parental distress within 48 hours of discharge,
indexed by PPD questionnaire such as EPDS
• Staff burnout, indexed by a validated instrument
such as the Maslach Burnout Inventory

Initiative Domains

Peer Support
Family-Centered Developmental Care
Mental Health Professionals
Palliative and Bereavement Care
Post-Discharge Support
Staff Education and Support

Initiative Reach
Target population
• All parents of infants hospitalized in the NICU
• All NICU staff
Target facilities
• All hospitals that provide NICU care

Initiative Impact
• This initiative will address unmet mental
health needs of NICU parents and staff
• Participating centers will collaborate in
implementing consensus recommendations
from a broad coalition of stakeholders
• Psychosocial support will enable parents and
staff to optimize care for medically fragile

Initiative Challenges / Barriers
• Staff will require additional training / in
services to screen for and address parental
psychosocial wellbeing
• Implementing referral and treatment will
require navigating local behavioral health

Supporting Materials

Supporting Materials