Stress of Prematurity in the Experience of the COVID-19 Pandemic—Current State of Knowledge
Abstract
:1. Introduction
2. Influence of COVID-19 on Pregnancy
3. Long-Term Complications Caused by Stress on Maternal and Offspring Outcomes
4. Influence of Stress on the Pregnancy Course
5. Influence of COVID-19 on the Pregnancy Course
6. Influence of Prematurity on the Mother and Family
7. The Impact of Vitamin D Deficiency Induced by the COVID-19 Pandemic on the Risk of Preterm Birth
- Impact on the Immune System:
- Regulation of Hormonal System:
- Inflammatory State:
- Impact on Vascular Function:
8. Influence of the COVID-19 Pandemic on the Stress
- Physical and emotional stress: Mothers of premature infants experience both physical and emotional stress, resulting from the need to adapt to new requirements related to caring for a premature baby in conditions of an epidemiological threat. In a published Italian study from 2021 that focused on the impact of the COVID-19 pandemic on parental stress, breastfeeding, and lactation success among mothers of premature infants whose children were in the neonatal intensive care unit (NICU), it was found that the availability of breast milk and breastfeeding decreased drastically (prior to the pandemic, the percentage of premature infants breastfed with breast milk was 86.1%, while during the pandemic, it was 44.8%). However, it was noted that the rate of breastfeeding was similar before and during the pandemic after the premature baby’s discharge from the hospital. Another study conducted by the University of Liverpool and the School of Health in Australia examined experiences related to the stress of prematurity using the social media platform Twitter. A total of 3161 tweets from parents of premature infants were analyzed. It was found that the COVID-19 pandemic and the associated restrictions, which affected parents’ contact with preterm infants, imposed significant emotional burdens on the studied group [76,80,88,89,90,91,92,93,94,95].
- Health safety concerns: Mothers of premature infants have heightened concerns about their children’s health in the context of the pandemic. These concerns primarily revolve around the risk of coronavirus infection, especially in the case of premature babies who are more susceptible to infections. This leads to increased anxiety and fear in women who have given birth before the due date. Spanish scientists from Torrecardenas University Hospital (between 2020 and 2022) focused on assessing the kangaroo mother care method in reducing anxiety and stress in women after preterm birth in the context of the COVID-19 pandemic. A cohort study was conducted on recruited mothers whose children were in the neonatal intensive care unit and participated in kangaroo mother care, and their stress levels were measured using the Parental Stressor: Neonatal Intensive Care Unit (PSS: NICU) scale and the STAI E/R questionnaire before and after implementing kangaroo care. It was proven that mothers in the group where kangaroo care had not yet been applied obtained higher scores on the PSS: NICU scale and the STAI E/R questionnaire compared to women who practiced kangaroo care. However, no statistically significant differences were found (p > 0.05). The result of this study highlights the importance of kangaroo care for the mental health of mothers, which was often impossible or limited during the COVID-19 pandemic. According to WHO, Kangaroo mother care has been demonstrated to reduce baby mortality by as much as 40%, hypothermia by more than 70%, and severe infections by 65% in infants delivered preterm or at low birthweight [76,80,88,89,90,91,92,93,94,95].
- Restrictions on accessing medical care: The COVID-19 pandemic and the associated restrictions significantly hindered access to medical care and contact with doctors. The difficult access to specialized medical care for premature infants, such as specialist doctor visits, rehabilitation, or diagnostics, created a higher level of stress for parents of preterm newborns. At the beginning of the pandemic noticed that clinics and rehabilitation centers suspended their operations during the lockdown, follow-up appointments, therapy, and psychological support services have been discontinued in many locations around the world. This has many parents extremely concerned for the unpredictable effects on their child’s health [76,80,88,89,90,91,92,93,94].
- Separation of the premature baby from parents: Uncertainty related to coronavirus infection and its health consequences necessitated extraordinary precautions and safety measures in medical facilities. During the initial phase of the pandemic, mothers were completely isolated from their newborn babies and often saw them for the first time after completion of treatment in the NICU. This prolonged separation caused significant anxiety and stress in mothers of premature infants [76,80,89,90,91,92,93,94].
- Altered care conditions: Due to the pandemic, the standard procedures for care in neonatal intensive care units (NICUs) had to be modified to ensure the safety of both healthcare staff and patients. These changes, such as the use of personal protective equipment (PPE) and limitations on visitation, created additional challenges and emotional strain for parents, particularly mothers of premature infants [76,80,89,90,91,92,93,94].
9. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Wagner, E.; Bień, K.; Łomża, A.; Grunwald, A.; Kimber-Trojnar, Ż.; Libera, A.; Leszczyńska-Gorzelak, B. Stress of Prematurity in the Experience of the COVID-19 Pandemic—Current State of Knowledge. Life 2023, 13, 1757. https://doi.org/10.3390/life13081757
Wagner E, Bień K, Łomża A, Grunwald A, Kimber-Trojnar Ż, Libera A, Leszczyńska-Gorzelak B. Stress of Prematurity in the Experience of the COVID-19 Pandemic—Current State of Knowledge. Life. 2023; 13(8):1757. https://doi.org/10.3390/life13081757
Chicago/Turabian StyleWagner, Emilia, Katarzyna Bień, Aleksandra Łomża, Arkadiusz Grunwald, Żaneta Kimber-Trojnar, Aneta Libera, and Bożena Leszczyńska-Gorzelak. 2023. "Stress of Prematurity in the Experience of the COVID-19 Pandemic—Current State of Knowledge" Life 13, no. 8: 1757. https://doi.org/10.3390/life13081757