Perinatal anxiety in mothers of neonatal intensive care unit-admitted neonates: A case–control study on prevalence and associated factors

Objectives: The objective is to study the prevalence of anxiety and its associated factors in mothers of neonates admitted to a neonatal intensive care unit (NICU), through case–control study in a tertiary care hospital, Punjab. The focus was exclusively on maternal perinatal anxiety, given the unique stresses of the NICU environment. Material and Methods: In this hospital-based cross-sectional case–control study, 160 mothers of preterm and/or low birth weight neonates in the NICU were compared to 160 mothers of healthy full-term neonates (controls). Participants (ages 18–45) were assessed using the Perinatal Anxiety Screening Scale (PASS) for anxiety. Key sociodemographic and clinical variables (age, education, socio-economic status, etc.) were recorded. Statistical analyses included Chi-square tests (or Fisher’s exact test) for categorical comparisons with significance at P < 0.05. All mothers were interviewed between 3 and 7-day postpartum while still admitted (inpatient department) in the obstetric ward (controls) or NICU (cases). In addition, participants were screened for depressive symptoms using the Edinburgh Postnatal Depression Scale, and mothers scoring ≥10 were excluded to avoid inclusion of postpartum depression or blues. Results: Mothers of NICU-admitted babies (cases) showed a statistically significant difference in prevalence of perinatal anxiety (PASS score ≥21) than mothers of healthy newborn babies (control) (92.5% vs. 70.6%, P < 0.001). Maternal age under 25 years, cesarean delivery, and having a female neonate were each significantly associated with heightened anxiety levels in NICU mothers (all P < 0.05). No significant differences in anxiety were found with respect to maternal education, occupation of the mother, socio-economic status, domicile, family structure, pregnancy planning, or previous history of abortion. Conclusion: Nearly all mothers with NICU-admitted neonates experienced clinically significant anxiety. Younger maternal age, cesarean birth, and a female newborn emerged as greater risk factors. These findings underscore the need for routine anxiety screening and tailored psychosocial support for mothers in the NICU setting to mitigate anxiety and improve outcomes for both mother and neonate.