Depression, Stress, and Health Behaviors
Among Mothers in the Neonatal Intensive Care Unit
1
B.S. ,
2
M.S. ,
Lauren DeRuyter,
Alexa Bonacquisti,
Victoria A. Grunberg,
2,3
4,5
Pamela A. Geller, Ph.D. , & Chavis A. Patterson, Ph.D.
2
B.A. ,
1  Drexel University, MMS Program 2 Drexel University; Dept. of Psychology 3 Drexel University College of Medicine; Dept. of Ob/Gyn
4 The Children’s Hospital of Philadelphia; Div. of Neonatology 5 Perelman School of Medicine at the University of Pennsylvania, Dept. of Psychiatry
Methods
Introduction
•  Parenting an infant in the NICU can be extremely distressing,
as parents must navigate complex medical systems while also
managing their own feelings of anxiety, stress, sadness, and
loss.
•  In particular, mothers with infants in the NICU may be at
greater risk for postpartum depression compared to women
who deliver full term infants (Beck, 2003).
•  Increased maternal stress increases the likelihood of
developing depressive and anxiety symptoms (Guillaume,
2013).
•  Caregivers, such as mothers of NICU infants, often neglect to
take care of themselves, which compounds their stress and
worsens mental health outcomes (Simpson & Carter, 2013).
•  Health-promoting behaviors have been shown to be related to
postpartum depressive symptoms, although this construct has
not been well-documented within this particular population.
Primary Objectives
Study Procedures
• Mothers are being recruited from 3 NICUs: Hahnemann
University Hospital in Philadelphia, PA, Cooper University
Hospital in Camden, NJ, and The Children’s Hospital of
Philadelphia.
• Researchers recruit and enroll potential participants at the
bedside in the NICU, and participants complete a survey.
• Time 1 participants are screened, consented, and administered
measures. Two-three months later, Time 2, we re-administered
measures (in person or via telephone) to evaluate their
depressive and stress symptoms and health behaviors.
Current Status & Preliminary Data
Currently, 57 participants have been enrolled and completed the
initial survey. Sixteen participants have completed the follow-up
survey.
Preliminary demographic data, categorized by recruitment site:
Hahnemann
University
Hospital
(N = 14)
1.  To examine the relationship between depression and healthpromoting behaviors in mothers of infants in the NICU
2.  To examine the relationship between stress and healthpromoting behaviors in mothers of infants in the NICU
Measures
Demographics and Psychosocial Assessment: Created 21
items specifically for this study
Depression: Edinburgh Postnatal Depression Scale (EPDS;
Cox, Holden & Sagovsky, 1987)
Stress: Depression, Anxiety, Stress Scales (DASS; Lovibond &
Lovibond, 1996)
Health Behaviors: Subscales: Check-up, Social, Stress, and
Exercise: The Multidimensional Health Behavior Inventory
(MHBI; Kulbok, Carter, Baldwin, Gilmartin & Kirkwood, 1999).
Contact information:
Lauren DeRuyter, B.S.
lmd344@drexel.edu
To evaluate the primary study aims, a series of bivariate correlations
were conducted.
Aim 1: There is a significant negative correlation between depressive
symptoms and social health behaviors (r = -.543, p <0.01), stress
behaviors (r = -.578, p <0.01), and exercise behaviors (r = -.365, p
<0.01).
Aim 2: There is a significant negative correlation between stress
symptoms and social health behaviors (r = -.342, p <0.05), stress
behaviors (r = -.364, p <0.01), and exercise behaviors (r = -.393, p
<0.01).
Cooper
University
Hospital
(N = 22)
The
Children’s
Hospital of
Philadelphia
(N = 18)
Age in years (M, SD)
27.71 (4.8)
28.64 (6.2)
30.72 (4.3)
Number of children (M,
SD)
2.36 (1.4)
1.95 (1.3)
2.44 (1.4)
Ethnicity: NonHispanic, African
American/Black (n, %)
n = 8, 57%
n = 6, 27%
n = 7, 39%
Educational level: High
school diploma (n, %)
n = 6, 43%
n = 7, 32%
n = 5, 28%
Employment status:
Employed full-time (n,
%)
n = 7, 50%
n = 12, 55%
n = 15, 83%
Relationship status:
Unmarried, living with
partner (n, %)
n = 5, 36%
n = 8, 36%
n = 6, 33%
March of Dimes
31.6%
n=6
Conclusion
Depression and health behaviors: Results indicate a negative
correlation between depressive symptoms and health behaviors.
Specifically, we identified that depressive symptoms may be
associated with negative social, stress, and exercise health
behaviors in postpartum women. This also suggests that these
health behaviors may dampen the effects of the so often stressful
situation mothers face with infants in the NICU. This will allow us to
better identify at-risk mothers and tailor preventive interventions to
highlight certain behaviors, thus improving both physical and mental
health outcomes.
Anxiety and health behaviors: Results indicate a negative
correlation between stress symptoms and health behaviors. In
particular, we identified that stress symptoms may be associated
with negative social, stress, and exercise health behaviors in
postpartum women. This also suggests that these health behaviors
may dampen the effects of the so often stressful situation mothers
face with infants in the NICU. This will allow us to better identify atrisk mothers and tailor preventive interventions to highlight certain
behaviors, thus improving both physical and mental health
outcomes.
Data collection is ongoing so that analyses can be fully powered.