Predictors of stress among mothers of neonates in the intensive care unit at a selected referral hospital, Rwanda

Abstract

Background: The neonatal intensive care unit (NICU) hospitalization of newborns poses significant stressors for mothers, affecting their well-being and family dynamics. Maternal stress in neonatal intensive care units (NICUs) significantly is escalated by numerous maternal and neonatal factors which when it is elevated affects both maternal and neonatal outcomes. Methodology: A descriptive, quantitative, cross-sectional study was conducted among 110 mothers. Data were collected using structured questionnaire and analyzed using IBM SPSS version 27.1 to deliver descriptive statistics, chi-square tests, t-tests and ANOVA to explore associations between various variables and maternal stress levels. Results: The study on 110 mothers with neonates In NICU at Kibungo Level II teaching hospital found that 84.6% of mothers experienced moderate stress levels during their neonate's NICU stay, with mean stress score of 33.58 (SD = 3.465), indicate a moderate overall stress level with 15.5% of mothers reported high stress levels. Using Chi square test, the study revealed that maternal stress levels were not significantly associated with neonatal birth weight (χ2 = 7.555, p = 0.109) or APGAR scores (χ2 = 0.008, p = 0.996). However, pregnancy complications were significantly linked to increased stress (χ2 = 11.508, p = 0.175). Computing logistic regression analysis, it was concluded that low birth weight (AOR = 2.35, p = 0.03), and lower APGAR scores (AOR = 2.10, p = 0.02) significantly predicted maternal stress. Maternal age (AOR = 1.41, p = 0.17) and NICU history (AOR = 1.89, p = 0.042) were also key predictors of maternal stress. Conclusion: This study showed the critical impact of demographic factors and neonatal health indicators in predicting maternal stress level in the NICU. Interventions aimed at supporting these mothers should consider their unique stressors and the context of NICU hospitalization. Educational interventions and targeted support policies are essential to alleviate maternal stress and improve overall maternal well- being. Future research should focus on longitudinal studies to explore additional factors influencing maternal stress in this population, evaluate the long-term effects of stress and assess the effectiveness of interventions in diverse cultural contexts