Neonatal Research Group Dresden

Literature Review


Postpartum anxiety and adjustment disorder in parents of infants with very low birth weight: Cross-sectional results from a controlled multicentre cohort study


There is an ongoing discussion about acute and prolonged mental health problems of parents of VLBW infants, whereby studies focusing on depression frequently neglected other mental health problems as anxiety or adjustment disorders. Based on data of the german longitudinal HaFEn-study, prevalence of and risk for postpartum anxiety disorders and adjustments was assessed via questionnaires as well as clinical interviews.



Summary of results

Data of 230 mothers and 173 fathers were included. Four to six weeks postpartum the risk for minor/major anxiety symptoms and adjustment disorders was higher in parents with VLBW infants compared to the term group, whereas the risk for anxiety disorders was not higher in parents with VLBW infants. The most important predictors for postpartum state anxiety were high trait anxiety,  the birth of a VLBW infant, high stress during birth, and low social support.



The study included data of families of preterm and term born children and  both mothers and fathers. Also, different aspects of postpartum anxiety via structured clinical interviews and psychometric questionnaires were assessed, so that it was possible to discuss the role of trait anxiety for postpartum symptoms and disorders.



The findings were cross-sectional, so temporal relationships could not be considered. External validity of the sample may be limited by inclusion criteria and drop-out of families, resulting in a lower-risk sample.

Practical conclusion

The preterm birth of a child can be a stressful event for every parent, but the study underlines the specific role of postpartum anxiety for the coping process and the importance to take personal traits and life circumstances into account. So, mothers and fathers with high trait anxiety and low social support may need further support to cope with NICU treatment requirements and to develop a sensitive relationship with their children.

Helle N, et al., Postpartum anxiety and adjustment disorders in parents of infants with very low birth weight: Cross-sectional results from a controlled multicentre cohort study. J Affect Disord 2016;194:128–134.



Written by:

Patricia Hinner, psychologist

(uploaded 03.05.2016)

©2013 Dimitrios Konstantelos