Pediatric Critical Care Medicine,
Journal Year:
2023,
Volume and Issue:
24(12), P. 1022 - 1032
Published: Aug. 21, 2023
Hospitalization
in
a
PICU
is
stressful
experience
for
children
and
their
parents,
with
many
experiencing
posttraumatic
stress
disorder
(PTSD)
after
discharge.
Risk
factors
may
include
preillness
traumatic
events,
such
as
adverse
childhood
experiences
(ACEs).
We
sought
to
assess
the
feasibility
of
screening
ACEs
parents
admitted
PICU,
prevalence,
association
post-PICU
PTSD
symptoms
them
children.Single-center
prospective
observational
study.Urban
academic
children's
hospital
from
January
December
2021.One
hundred
forty-five
(2-18
yr
old,
≥
2
d)
parents.None.Data
on
parental
demographics,
ACEs,
coping
skills,
environmental
stressors,
well
patient
clinical
data,
were
collected.
One
month
discharge,
completed
inventories
assessing
children.
Bivariate
logistic
regression
analyses
used
explore
associations
PTSD.
Of
145
enrolled
95%
ACE
questionnaire,
58%
whom
reported
greater
than
or
equal
1
ACE,
14%
had
substantial
(≥
4)
ACEs.
Parent
follow-up
was
79%
70%,
respectively.
Sixteen
percent
provisional
Regression
analysis
showed
4
10
times
odds
PTSD,
compared
less
(adjusted
ratio
[aOR]
=
10.2;
CI,
1.03-100.9;
p
0.047).
Fifty-six
patients
screened
at
risk
There
no
between
patients'
(aOR
3.5
[95%
0.56-21.31];
0.18).ACEs
common
among
critically
ill
Having
associated
child's
admission,
but
not
Family-centered
care
that
seeks
mitigate
should
be
mindful
potential
relevance
Birth Defects Research,
Journal Year:
2019,
Volume and Issue:
111(15), P. 1087 - 1109
Published: June 3, 2019
Abstract
Maternal‐neonate
separation
for
human
newborns
has
been
the
standard
of
care
since
last
century;
low
birth
weight
and
preterm
infants
are
still
routinely
separated
from
their
mothers.
With
advanced
technology,
survival
is
good,
but
long‐term
developmental
outcomes
very
poor
these
especially
vulnerable
newborns.
The
similar
to
those
described
adversity
in
childhood,
ascribed
toxic
stress.
Toxic
stress
defined
as
absence
buffering
protection
adult
support.
Parental
strictly
enforced
neonatal
units
many
reasons
could
lead
understanding
comes
discoveries
about
our
genome
epigenetics,
microbiome,
neuroscience
brain
connectome,
life
history
theory.
common
factor
early
environment
that
gives
(a)
signals
epigenes,
(b)
sensory
inputs
neural
circuits,
(c)
experiences
reproductive
fitness.
For
direct
skin‐to‐skin
contact
birth.
Highly
conserved
neuroendocrine
behaviors
determined
by
this
review.
scientific
rationale
underlying
presented:
autonomic
development
regulation
physiology
leads
emotional
connection
achieving
resilience.
prevents
critical
processes
taking
place,
also
channel
into
an
alternative
strategy.
This
enables
better
coping
a
stressful
short
term,
with
permanently
elevated
systems
negatively
impact
mental
physical
health
long
term.
may
explain
increasing
incidence
problems
Developmental
Origins
Health
Disease.
Arguments
presented
maternal‐neonate
indeed
source
stress,
some
suggestions
offered
toward
“zero
separation”
paradigm.
Life,
Journal Year:
2023,
Volume and Issue:
13(2), P. 300 - 300
Published: Jan. 21, 2023
Birth
is
a
physiological
act
that
part
of
the
morpho-functional
economy
maternal
body.
Each
stage
in
birth
has
predetermined
pathway
neurohormonally
induced
and
morpho-functionally
established
through
specific
characteristic
adaptations.
Like
maternity,
childbirth
also
an
important
impact
on
body
as
biological
structure
psycho-emotional
behavior.
Cesarean
section
performed
at
request
mother
with
no
medical
underlying
conditions
besides
prolonged
hospitalization
risk
can
cause
breathing
problems
children,
delayed
breastfeeding,
possible
complications
future
pregnancy.
Vaginal
remains
path
choice
for
evolution
Although
erroneously
considered
safe
easy
today,
cesarean
delivery
must
remain
emergency
procedure
or
recommended
pregnancies
where
to
child,
itself
factor
negative
outcomes
both
baby.
This
review
summarizes
natural
have
newborn
their
attempt
adapt
postpartum
events
extrauterine
life.
NeoReviews,
Journal Year:
2021,
Volume and Issue:
22(8), P. e496 - e505
Published: Aug. 1, 2021
Parental
experiences
in
the
NICU
are
often
characterized
by
psychological
stress
and
anxiety
following
birth
of
a
critically
ill
or
premature
infant.
Such
can
have
negative
impact
on
parents
their
vulnerable
infants
during
hospitalization
as
well
after
discharge.
These
also
at
increased
risk
for
adverse
developmental,
cognitive,
academic,
mental
health
outcomes.
Identifying
distress
is
important
feasible
with
use
well-validated
screening
instruments.
Screening
essential
identifying
families
need
referral
support
resources.
Numerous
interventions
been
implemented
to
parents.
include
staff-based
such
wellness
rounds
education
developmental
care
parental-based
that
includes
cognitive
behavioral
therapy
home
visitation
programs.
Comprehensive
should
multidisciplinary
approach
involves
not
only
staff
but
key
stakeholders
social
workers,
spiritual/religious
representatives,
specialists
care,
psychiatrists/psychologists
help
facilitate
transition
home.
Future
efforts
raising
awareness
stresses
encouraging
development
programs
provide
support.
