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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Research article

A randomized controlled clinical trial of the effect of supportive counseling on mental health in Iranian mothers of premature infants

Authors: Leila Seiiedi-Biarag, Mojgan Mirghafourvand, Khalil Esmaeilpour, Shirin Hasanpour

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

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Abstract

Background

Premature birth can affect maternal mental health. Considering that the mental health disorder in mothers may play a vital role in the growth and development of their children, therefore, this study was conducted to determine the effect of supportive counseling on mental health (primary outcome), mother-child bonding and infant anthropometric indices (secondary outcomes) in mothers of premature infants.

Methods

This randomized controlled clinical trial was carried out on 66 mothers with hospitalized neonates in the NICU of Alzahra hospital in Tabriz- Iran. Participants were randomly allocated into two groups of intervention (n = 34) and control (n = 32) through a block randomization method. The intervention group received 6 sessions of supportive counseling (45–60 minutes each session) by the researcher, and the control group received routine care. Questionnaires of Goldberg General Health and the postpartum bonding were completed before the intervention (first 72 hours postpartum) and 8 weeks postpartum. Also, the anthropometric index of newborns were measured at the same time.

Results

There was no statistically significant difference between the two groups in terms of socio-demographic characteristics. After the intervention, based on ANCOVA with adjusting the baseline score, mean score of mental health (AMD: -9.8; 95% Confident Interval (95% CI): -12.5 to -7.1; P < 0.001) and postpartum bonding (AMD: -10.0; 95% CI: -0.6 to 13.9; P < 0.001) in the counseling group was significantly lower than those of the control group; however, in terms of weight (P = 0.536), height (P = 0.429) and head circumference (P = 0.129), there was no significant difference between the two groups.

Conclusions

Supportive counseling may improve mental health and postpartum bonding in mothers of premature infants. Thus, it may be recommendable for health care providers to offer it to mothers.

Trial registration

Iranian Registry of Clinical Trials (IRCT): IRCT201207180103​24N45. Date of registration: October 29, 2018.
Literature
1.
Blencowe H, Cousens S, Chou D, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013;10(Suppl 1):2.CrossRef
2.
3.
Sharifi N, Khazaeian S, Pakzad R. Investigating the prevalence of preterm birth in Iranian population: a systematic review and meta-analysis. J Caring Sci. 2017;6(4):371–80.PubMedPubMedCentralCrossRef
4.
Vohr BR, Wright LL, Dusick AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993–1994. Pediatrics. 2000;105(6):1216–26.PubMedCrossRef
5.
Doyle LW, Anderson PJ, Haslam R, et al. School-age outcomes of very preterm infants after antenatal treatment with magnesium sulfate vs placebo. JAMA. 2014;312(11):1105–13.PubMedCrossRef
6.
Mutlu FM, Sarici SU. Treatment of retinopathy of prematurity: a review of conventional and promising new therapeutic options. Int J Ophthalmol. 2013;6(2):228–36.PubMedPubMedCentral
7.
Wroblewska-Seniuk K, Greczka G, Dabrowski P, et al. Hearing impairment in premature newborns-analysis based on the national hearing screening database in Poland. PLoS One. 2017;12(9):e0184359.PubMedPubMedCentralCrossRef
8.
Lindberg B, Öhrling K. Experiences of having a prematurely born infant from the perspective of mothers in northern Sweden. Int J Circumpolar Health. 2008;67(5):461–71.PubMedCrossRef
9.
Roque ATF, Lasiuk GC, Radünz V, et al. Scoping review of the mental health of parents of infants in the NICU. J Obstet Gynecol Neonatal Nurs. 2017;46(4):576–87.PubMedCrossRef
10.
Borimnejad L, Mehrnoush N, Seyyed Fatemi N, et al. Maternal stressor agents with premature infants in neonatal intensive care units. Iran J Crit Care Nurs. 2011;4:39–44.
11.
Montirosso R, Provenzi L, Calciolari G, et al. Measuring maternal stress and perceived support in 25 Italian NICUs. Acta Paediatr. 2011;101(2):136–42.PubMedCrossRef
12.
Holditch-Davis D, Miles MS, Weaver MA, et al. Patterns of distress in African American mothers of preterm infants. J Dev Behav Pediatr. 2009;30(3):193–205.PubMedPubMedCentralCrossRef
13.
Mensah FK, Kiernan KE. Parents’ mental health and children’s cognitive and social development: families in England in the Millennium Cohort Study. Soc Psychiatry Psychiatr Epidemiol. 2010;45(11):1023–35.PubMedCrossRef
14.
Kahn RS, Brandt D, Whitaker RC. Combined effect of mothers’ and fathers’ mental health symptoms on children’s behavioral and emotional well-being. Arch Pediatr Adolesc Med. 2004;158(8):721–9.PubMedCrossRef
15.
Ronda V. The effect of maternal psychological distress on children’s cognitive development. Working paper. 2016.
16.
17.
18.
Nematbakhsh F, Kordi M, Sahebi A, et al. The effect of mother–infant skin to skin contact on mother’s attachment. J Fundamentals Ment Health. 2007;9:25–32.
19.
Bozzette M. A review of research on premature infant-mother interaction. Newborn Infant Nurs Rev. 2007;7(1):49–55.CrossRef
20.
21.
Patel V, Rahman A, Jacob KS, Hughes M. Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia. BMJ. 2004;328(7443):820–3.PubMedPubMedCentralCrossRef
22.
23.
Evans T, Whittingham K, Boyd R. What helps the mother of a preterm infant become securely attached, responsive and well-adjusted? Infant Behav Dev. 2012;35(1):1–11.PubMedCrossRef
24.
Shaw RJ, St John N, Lilo EA, et al. Prevention of traumatic stress in mothers with preterm infants: a randomized controlled trial. Pediatrics. 2013;132(4):e886-94.PubMedCrossRef
25.
Logsdon MC, Davis DW. Guiding mothers of high-risk infants in obtaining social support. MCN Am J Matern Child Nurs. 1998;23(4):195–9.PubMedCrossRef
26.
Glavin K, Smith L, Sørum R, et al. Supportive counselling by public health nurses for women with postpartum depression. J Adv Nurs. 2010;66(6):1317–27.PubMedCrossRef
27.
Cuijpers P, Driessen E, Hollon SD, et al. The efficacy of non-directive supportive therapy for adult depression: a meta-analysis. Clin Psychol Rev. 2012;32(4):280–91.PubMedCrossRef
28.
29.
Demissie K, Rhoads GG, Ananth CV, et al. Trends in preterm birth and neonatal mortality among blacks and whites in the United States from 1989 to 1997. Am J Epidemiol. 2001;154(4):307–15.PubMedCrossRef
30.
31.
Ghafari F, Pourghazneyn T, Mazloom SA. The mental health of women and their husbands during pregnancy and postpartum in health care center of Ramsar. Iran J Obstet Gynecol Infertil. 2005;8:73–80.
32.
Goldberg DP. The detection of psyshiatric illness by questionnaire; a technique for the identification and assessment of non-psychotic psychiatric illness. Second edition. Maudsley Monograph No. 21. New York: Oxford University Press; 1972.
33.
Noorbala A, Mohammad K. The validation of General Health Questionnaire-28 as a psychiatric screening tool. Hakim Res J. 2009;11(4):47–53.
34.
Nazifi M, Mokarami H, Akbaritabar A, et al. Reliability, validity and factor structure of the persian translation of general health questionnaire (GHQ-28) in hospitals of Kerman University of Medical Sciences. J Fasa Univ Med Sci. 2014;3(4):336–42.
35.
Brockington I, Fraser C, Wilson D. The postpartum bonding questionnaire: a validation. Arch Womens Ment Health. 2006;9(5):233–42.PubMedCrossRef
36.
Aflakseir A, Jamali S. Relationship between mother-child bonding with postpartum depression among a group of mothers in Shiraz-Iran. Prev Care Nurs Midwifery J. 2014;3(2):61–9.
37.
Kohan M, Borhani F, Abbaszadeh A, et al. Experience of mothers with premature infants in neonatal. J Qual Res Health Sci. 2012;1(1):41–51.
38.
Ghodrati TA, Abbaspour S, Hassanzadeh M, et al. The effect of neonatal care training on anxiety in mothers of premature. J Torbat Heydariyeh Univ Med Sci. 2014;2(2):25–30.
39.
Valizadeh L, Hosseini MB, Damanabad ZH, et al. Effect of NICU department orientation program on mother’s anxiety: a randomized clinical trial. J Caring Sci. 2016;5(3):205–14.PubMedPubMedCentralCrossRef
40.
Karami SR, Ghadirian F. Effect of educational-supportive interventions on premature infants’ lentgh of hospitalization and maternal stress. Yafteh. 2009;11(2):67–73.
41.
Turan T, Başbakkal Z, Özbek Ş. Effect of nursing interventions on stressors of parents of premature infants in neonatal intensive care unit. J Clin Nurs. 2008;17(21):2856–66.PubMedCrossRef
42.
Parvin N, Kazemian A, Alavi A, et al. The effect of supportive group therapy on menopause mental health. J Gorgan Univ Med Sci. 2007;9(3):74–9.
43.
Moghadasi M, Azizzadeh Foroz M, Mahdizadeh A, et al. The effect of supportive counseling on reducing the anxiety of women at risk of preterm birth. J Urmia Nurs Midwifery Fac. 2016;14(2):151–8.
44.
Kong G, Chung T, Lok I. The impact of supportive counselling on women’s psychological wellbeing after miscarriage–a randomised controlled trial. BJOG. 2014;121(10):1253–62.PubMedCrossRef
45.
Mojrian M, Tirgari B, Mehdizadeh A, et al. The effect of supportive counseling on the symptoms of acute stress disorder following emergency cesarean section. J Midwifery Reprod Health. 2018;6(2):1208–14.
46.
Chourasia N, Surianarayanan P, Bethou A, et al. Stressors of NICU mothers and the effect of counseling—experience from a tertiary care teaching hospital, India. J Matern Fetal Neonatal Med. 2013;26(6):616–8.PubMedCrossRef
47.
Azizi M, Lamyian M, Faghihzade S, et al. The effect of counseling on anxiety after traumatic childbirth in nulliparous women: a single blind randomized clinical trial. Behbood. 2010;14(3):219–27.
48.
Gamble JA, Creedy DK, Webster J, et al. A review of the literature on debriefing or non-directive counselling to prevent postpartum emotional distress. Midwifery. 2002;18(1):72–9.PubMedCrossRef
49.
Osman H, Saliba M, Chaaya M, et al. Interventions to reduce postpartum stress in first-time mothers: a randomized-controlled trial. BMC Womens Health. 2014;14:125.PubMedPubMedCentralCrossRef
50.
Parker L. Mothers’ experience of receiving counselling/psychotherapy on a neonatal intensive care unit (NICU). J Neonatal Nurs. 2011;17(5):182–9.CrossRef
51.
Priest SR, Henderson J, Evans SF, et al. Stress debriefing after childbirth: a randomised controlled trial. Med J Aust. 2003;178(11):542–5.PubMedCrossRef
52.
Moghaddam Tabrizi F, Nournezhad H. The effect of family support based counselling on postnatal perceived stress and mother-child bonding in nulliparous women to health centers in Urmia in 2016–2017. J Nurs Midwifery Urmia Univ Med Sci. 2018;16(2):109–21.
53.
Bostanabad MA, Areshtanab HN, Balila M, et al. Effect of a supportive-training intervention on mother-infant attachment. Iran J Pediatr. 2017;27(6):e10565.
54.
Badr LK. Is the effect of postpartum depression on mother-infant bonding universal? Infant Behav Dev. 2018;51:15–23.PubMedCrossRef
55.
Mardazad N, Nahidi F, Jannasari S, Amiri Z. Assessment of effect of mother consulting on weighting of low birth weight neonate. Jentashapir J Health Res. 2012;3(3):417–26.
56.
Leksomono N, Sutomo R, Haksari EL. Predictors of early growth failure in preterm, very low birth weight infants during hospitalization. Paediatr Indones. 2019;59(1):44–50.CrossRef
57.
Masoumi S, Ahmadi S, Parsa P, Roshanaei G, Basiri B. Effects of counseling on adherence to exclusive breastfeeding in mothers of hospitalized late preterm infants in Fatemieh hospital, Hamadan, Iran, 2014. Avicenna J Nurs Midwifery Care. 2015;23(3):72–81.
Metadata
Title
A randomized controlled clinical trial of the effect of supportive counseling on mental health in Iranian mothers of premature infants
Authors
Leila Seiiedi-Biarag
Mojgan Mirghafourvand
Khalil Esmaeilpour
Shirin Hasanpour
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03502-w

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