A pilot study on assessing parental stress in Romanian NICU and exploring parental mental health outcomes

Background and objectives. Preterm birth and neonatal hospitalization in a Neonatal Intensive Care Unit (NICU) represent major stressors for parents, often associated with elevated levels of anxiety, depression, and psychological distress. This pilot study aimed to (1) conduct a preliminary cultural validation of the Romanian version of the PSS:NICU scale and (2) evaluate maternal stress, anxiety, and depressive symptoms in mothers of preterm and term newborns hospitalized in NICU. Materials and methods. A cross-sectional pilot study was conducted between April and August 2025 at the NICU of Mureș County Emergency Clinical Hospital. A total of 22 postpartum mothers (15 with preterm births and 7 with term births) were included. Instruments used: PSS:NICU (Romanian version), Beck Depression Inventory-II (BDI-II), and State-Trait Anxiety Inventory (STAI-Y1 and Y2). Descriptive and inferential statistics were applied. Internal consistency was assessed using Cronbach’s Alpha. Results. Mothers of preterm infants showed higher mean scores for anxiety and depression compared to mothers of term infants, though differences were not statistically significant. PSS:NICU responses from six mothers of preterm infants indicated elevated stress levels, particularly in the Parental Role and Relationship and Infant Appearance and Behavior domains. The Romanian version of PSS:NICU demonstrated excellent internal consistency for most domains, with slightly lower reliability in the Visual and Auditive domain. Conclusions. The Romanian version of the PSS:NICU scale shows promising psychometric properties and can be used in future research. The results highlight increased psychological vulnerability in mothers of preterm infants and underscore the need for systematic psychological screening and culturally adapted perinatal support protocols in Romanian NICUs.