The Effect of Supportive Counseling on Mother Mental Health of Premature Infants: A Randomized Controlled Clinical Traial

Abstract

Abstract: Background: Preterm birth is one of the main causes of parent’s mental disorder. Since mental disorders of parents, especially mothers, can affect the development of children, this study aimed to investigate the effect of supportive counseling on mental health (primary outcome) and postpartum bonding and infant anthropometric indices (secondary outcomes) in mothers of premature infants Methods: This study was a randomized controlled clinical trial with two equal arms and allocation ratio 1:1, that was conducted on 66 mothers of premature infans that their infants were admitted to the neonatal intensive care unit (NICU) of Alzahra hospital in Tabriz with gestational age 28 to 33 weeks and 6 days. Participants were randomly assigned into two groups; intervention (n = 34) and control (n = 32) groups using block randomization with block sizes 4 and 6 and. The intervention group received supportive counseling for 6 sessions (45-60 minutes each session) by the researcher and the control group received routine care. The questionnaire of Goldberg General Health Questionnaire (GHQ) (primary outcome) and postpartum bonding questionnaire (PBQ) were completed before and 8 weeks after intervention. Anthropometric indices of newborns at birth eight weeks after childbirth were recorded in the related checklist by researcher. Independent t-test and ANCOVA were used for data-analysis. Results: The mean (SD) of the total mental health score before the intervention was 19.8 (2.4) in the counseling group and 18.6 (2.6) in the control group. There was a statistically significant difference between the two groups before intervention based on the independent t-test (P= 0.048). The mean (SD) of the total mental health score after intervention in the counseling group and control group was 14.0 (4.8) and 22.6 (7.0), respectively, which was significantly lower in the intervention group than in the control group based on ANCOVA with adjusting the baseline values (Mean Difference: -9.8; 95% Confident Interval: -12.5 to -7.1; P<0.001). The mean (SD) of the total postpartum bonding score before the intervention was 18.7 (9.1) in the counseling group and 14.9 (9.6) in the control group. There was no statistically significant difference between the two groups before intervention based on the independent t-test (P= 0.098). The mean (SD) of the total postpartum bonding score after the intervention was 8 (3.1) and 17.6 (10.5) in the counseling and control groups, respectively, which was significantly lower in the intervention group than in the control group based on ANCOVA with adjusting the baseline values (Mean Difference: -10.0; 95% CI: -0.6 to 13.9; P<0.001). At eight weeks postpartum, there was no significant difference in terms of weight (P = 0.536), height (P = 0.429) and head circumference (P = 0.129) between the two groups. Conclusion: Supportive counseling can improve mental health and postpartum bonding in mothers of premature infants, so it can be recommended to health care providers to provide them to mothers.