Implementation of a Structured Mother-Infant Reading Program to Reduce Postpartum Depression and Maternal Stress and Measure Infant Physiologic Stability in the NICU

Background: NICU mothers are at greater risk for postpartum depression and altered maternal infant bonding. Care participation through reading may reduce PPD and stress, enhance maternal infant attachment, and promote physiologic stability in the premature infant.

Purpose: The purpose of this study was to evaluate the implementation of a NICU based reading program on depression and stress and to determine the effect of maternal voice exposure on infant heart rate and SpO2 readings.

Methods: Fourteen mother infant dyads, including a set of fraternal twins, were enrolled in the NICU Reading Garden and received nurse practitioner delivered education, support, and behavior re-enforcement. Depression and stress scores were measured pre and post intervention. Based on reading logs, infant heart rate and SpO2 were assessed at three time points.

Results: Depression scores (Md=9 vs Md=3, p= 0.007) and stress scores related to infant behaviors (p=0.0498) and parental role alterations (p=0.04) of mothers of singletons declined. The majority (92.8%) felt closer to their baby and all planned to read to their baby after discharge. There was an increase in infant mean SpO2 during reading compared to after reading (p=0.002).

Nursing Implications: Implementation of a reading program is feasible and has an effect on both maternal and neonatal outcomes, supporting family centered care initiatives.

Research Implications: Future research should focus on the recognition of emotional patterns associated with PPD, triggers of maternal stress, and the impact of maternal voice exposure in the early neonatal period on language acquisition and childhood literacy long term.