Stress levels and dimensions among mothers of newborns in Neonatal Intensive Care Units

Authors

DOI:

https://doi.org/10.36517/2175-6783.20262796457

Keywords:

Mothers; Stress, Psychological; Intensive Care Units, Neonatal; Infant, Newborn; Psychological Tests.

Abstract

Objective: to assess the level and dimensions of stress among mothers of newborns admitted to neonatal intensive care units. Methods: this cross-sectional, analytical, exploratory study included 81 mothers. Data were collected using the Parental Stress Scale: Neonatal Intensive Care Unit, which had been translated, adapted, and validated for use with the Brazilian population. The scale comprises three dimensions: “Sights and Sounds,” “Infant Appearance and Behaviour,” and “Parental Role Alteration.” Descriptive and inferential analyses were  performed. Results: the "Sights and sounds" dimension showed the lowest levels of maternal stress, with means of 2.46 and 2.40 and a classification of low stress. The "Infant appearance and behavior" dimension indicated moderate stress (means: 3.40 and 3.21). Conversely, the "Parental role alteration" dimension showed the highest scores (means: 4.32 and 4.31), which indicates high stress. Overall, the mean was 3.43 (metric 1) and 3.32 (metric 2), which indicates moderate stress. Conclusion: mothers experienced high levels of stress, particularly related to parental role alteration. Contributions to practice: such findings highlight the need for strategies to identify and reduce maternal stress, which should promote greater parental involvement, improve communication, and provide emotional support within the neonatal intensive care environment.

Downloads

Download data is not yet available.

References

1. Jha P, Tripathi S, Kar SK. Parental stress, psychological well-being and sleep quality of mothers of neonates hospitalized in the Neonatal Intensive Care Unit of a tertiary care hospital in North India: a cross-sectional study. Clin Epidemi Glob Health. 2025;35:102139. doi: https://doi.org/10.1016/j.cegh.2025.102139

2. Alves TF, Limberger DC, Hausen CF, Silva JC, Souza NS, Jantsch LB. Parental stress contexts in a neonatal Intensive care unit. Rev Contexto Saúde. 2025;25(50):e14950. doi: https://dx.doi.org/10.21527/2176-7114.2025.50.14950

3. Murless-Collins S, Ezeaka VC, Masoud NS, Walker K, Rhoda NR, Keenan W, et al. Born Too Soon: Care for small and sick newborns, evidence for investment and implementation. Reprod Health. 2025; 22(Suppl 2):114. doi: http://dx.doi.org/10.1186/s12978-025-02032-y

4. Aguiar JRV, Dornelles C, Prado ARA, Prado FM, Barros FCLF, Arrieira RO. Avaliação das internações dos recém-nascidos em uma UTI Neonatal durante uma pandemia. Rev Urug Enferm. 2022;17(2):e202. doi: https://doi.org/10.33517/rue2022v17n2a7

5. Rambod M, Pasyar N, Mazarei Z, Soltanian M. The predictive roles of parental stress and intolerance of uncertainty on psychological well-being of parents with a newborn in neonatal intensive care unit: a hierarchical linear regression analysis. BMC Pediatr. 2023;23(1):607. doi: https://dx.doi.org/10.1186/s12887-023-04420-4

6. Kegler JJ, Neves ET, Silva AM, Oliveira DC, Zamberlan KC. Factors associated with parental stress in a Neonatal Intensive Care Unit. Acta Paul Enferm. 2023;36:eAPE024567. doi: https://dx.doi.org/10.1590/1982-019420230024567

7. Konukbay D, Vural M, Yildiz D. Parental stress and nurse-parent support in the neonatal intensive care unit: a cross-sectional study. BMC Nurs. 2024;23(1):820. doi: https://dx.doi.org/10.1186/s12912-024-02458-y

8. Oliveira LSM, Costa EF, Brito SFS, Pontes FAR, Silva SSC. Parental stress and associated symptoms in premature babies’ parents: a systematic review. Estud Psicol (Campinas). 2023;40:e210114. doi: https://doi.org/10.1590/1982-0275202340e210114

9. Costa MCS, Santos ECA, Santos NCS, Gouveia MTO, Dantas ALB. Clinical and epidemiologic profile of newborns admitted to neonatal care units of a high-risk maternity hospital. Rev Enferm Ref. 2025;6(4):e37236. doi: https://doi.org/10.12707/RVI24.87.37236

10. Souza SR, Dupas G, Balieiro MMFG. Cultural adaptation and validation for the Portuguese language of the Parental Stress Scale: Neonatal Intensive Care Unit (PSS:NICU). Acta Paul Enferm. 2012;25(2):171-6. doi: https://doi.org/10.1590/S0103-21002012000200003

11. Miles MS, Funk SG, Carlson J. Parental Stressor Scale: neonatal intensive care unit. Nurs Res [Internet]. 1993 [cited Nov 18, 2025];42(3):148-52. Available from: http://pubmed.ncbi.nlm.nih.gov/8506163/

12. Brondani AS, Jantsch LB, Jacobi LF. Factors associated with parental stress in neonatal intensive care units: cross-sectional study. Rev Bras Saúde Matern Infantil. 2024;24(1):e37236. doi: http://doi.org/10.1590/1806-93042024000037236

13. Gomez DB, Valente EP, Dalena P, Mariani I, Vidal SA, Mello MJG, et al. Parental stress, depression, anxiety, and participation in Neonatal Care in a Referral Brazilian NICU over different phases of the COVID-19 pandemic. Children. 2025;12(4):496. doi: https://doi.org/10.3390/children12040496

14. Joshi A, Agarwal B, Saini V, Javvaji CK. Assessment of stress and anxiety in parents of neonates admitted in a tertiary care Neonatal Intensive Care Unit (NICU). Cureus. 2024;16(8):e66100. doi: https://doi.org/10.7759/cureus.66100

15. Tzeli M, Alexiou M, Sarantaki A, Kyrkou G, Charalampopoulos D, Biti S, et al. Psychometric Validation of the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) in a Greek cohort of parents of hospitalized Neonates. Healthcare. 2025;13(21):2750. doi: https://doi.org/10.3390/healthcare13212750

16. Zych B, Błaż W, Kanadys K, Dmoch-Gajzlerska E, Nagórska M. Differences in parental stress in mothers and fathers of preterm infants: a prospective study in Poland. Eur J Midwifery. 2025;9:1-9. doi: http://doi.org/10.18332/ejm/200552

17. Almeida NS, Goldstein RA. Impactos psíquicos nas vivências de mães de bebê com extremo baixo peso internado em UTI Neonatal. Rev SBPH. 2022;25(1):84-96. doi: http://doi.org/10.57167/Rev-SBPH.v25.030

18. Ramos BA, Formiga CKMR, Oliveira NRG, Marçal PGE, Ferreira RG, Saidah TK, et al. Relationship between maternal stress and neurobehavioral indicators of preterm infants in the neonatal intensive care unit. Children. 2024;11(8):889. doi: https://doi.org/10.3390/children11080889

19. Pettengill MAM, Angelo M. Vulnerabilidade da família: desenvolvimento do conceito. Rev Latino-am Enfermagem. 2005;13(6):982-8. doi: https://doi.org/10.1590/S0104-11692005000600010

20. Pavlyshyn H, Sarapuk I. What influences maternal stress in the NICU among mothers of preterm infants? J Multidiscip Healthc. 2025;18:5713-28. doi: https://doi.org/10.2147/JMDH.S543911

21. Tilahun BD. Parental stress and associated factors among parents of preterm neonates admitted at neonatal intensive care unit among selected governmental hospitals Addis Ababa, Ethiopia, 2022. An institution-based cross-sectional study. Front Psychiatry. 2024;15:1377180. doi: https://doi.org/10.3389/fpsyt.2024.1377180

22. Pavlyshyn Н, Sarapuk I, Saturska U. Maternal stress experience in the neonatal intensive care unit after preterm delivery. Am J Perinatol. 2024;41(9):1155-62. doi: http://doi.org/10.1055/s-0042-1747942

23. Fróes GF, Mendes ENW, Pedroza GA, Cunha MLC. Stress experienced by mothers of preterm newborns in a neonatal intensive care unit. Rev Gaúcha Enferm. 2020;41(esp):e20190145. doi: https://doi.org/10.1590/1983-1447.2020.20190145

24. Hendy A, El-sayed S, Bakry S, Mohammed SM, Mohamed H, Abdelkawy A, et al. The stress levels of premature infants’ parents and related factors in NICU. SAGE Open Nurs. 2024; 10:23779608241231172. doi: https://dx.doi.org/10.1177/23779608241231172

25. Siva N, Phagdol T, Nayak BS, Mathias EG, Lewis LES, Velayudhan B, et al. Stress and stressors experienced by the parents of high‐risk neonates admitted in neonatal intensive care unit: Systematic review and meta‐analysis evidence available from India. Stress Health. 2024;40(2):e3301. doi: https://doi.org/10.1002/smi.3301

Published

2026-04-10

Data Availability Statement

The authors declare that data supporting the findings of this study are fully presented within the article.

Issue

Section

Research Article

How to Cite

1.
Oliveira ET de A, Costa MC da S, Santos GPG, Dantas ALB, Costa GR da, Gouveia MT de O. Stress levels and dimensions among mothers of newborns in Neonatal Intensive Care Units. Rev Rene [Internet]. 2026 Apr. 10 [cited 2026 Apr. 12];27:e96457. Available from: https://periodicos.ufc.br/rene/article/view/96457