{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T17:28:09Z","timestamp":1794590889067,"version":"4.9.1"},"reference-count":48,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"\n \n <\/jats:sec>\n \n OBJECTIVES<\/jats:title>\n To assess the prevalence, potential perinatal predictors, and longitudinal trajectory of parental anxiety in mothers and fathers of infants up to 24\u00a0months corrected age.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n In this prospective cohort study, 298 mothers and 234 fathers of 315 infants (gestational age &lt; 30\u00a0weeks and\/or birth weight &lt; 1000\u00a0g) completed the State-Trait Anxiety Inventory (STAI) at 6, 12, and 24\u00a0months corrected age. Multilevel linear modeling estimated mean anxiety scores over time, and regression analyses examined associations with perinatal and neonatal risk factors.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n At 6\u00a0months, 69 of 273 mothers (25.3%) and 33 of 195 fathers (16.9%) reported clinically significant anxiety (STAI-state \u2265 40), with mothers more frequently affected (P\u2009=\u2009.031). Maternal anxiety prevalence declined to 22.2% (n\u2009=\u200947\/212) at 12\u00a0months and 20.0% (n\u2009=\u200935\/175) at 24\u00a0months, whereas paternal anxiety prevalence remained stable\u00a0at 15.0% (n\u2009=\u200923\/153) and 17.6% (n\u2009=\u200923\/131). Differences between parents were not significant afterward. No consistent associations were found with gestational age, birth weight, neonatal morbidities, or other perinatal risk factors. Multilevel modeling showed that mothers\u2019 mean anxiety scores decreased from 35.07 at 6\u00a0months to 33.45 at 12\u00a0months (\u22121.62, P\u2009=\u2009.015) and 32.72 at 24\u00a0months (overall \u22122.35, P\u2009=\u2009.001). Fathers scored 2.74 points lower than mothers at 6\u00a0months (P\u2009&lt;\u2009.001) and showed no significant changes over time.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n A substantial proportion of parents of neonatal intensive care unit\u2013treated infants, particularly mothers, experience elevated anxiety symptoms beyond discharge. These findings emphasize the importance of systematic, long-term mental health screening and support for both parents independent of their infant\u2019s medical complexity.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2025-074834","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:02:18Z","timestamp":1783987338000},"source":"Crossref","is-referenced-by-count":1,"title":["Parental Anxiety Trajectories 2 Years After NICU Discharge"],"prefix":"10.1542","volume":"158","author":[{"given":"Lois C.","family":"Span","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Beatrix Children\u2019s Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke H.","family":"van Dokkum","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Beatrix Children\u2019s Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik J.","family":"ter Horst","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Beatrix Children\u2019s Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth M. W.","family":"Kooi","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Beatrix Children\u2019s Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arend F.","family":"Bos","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Beatrix Children\u2019s Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"issue":"9","key":"2026101308572849500_r1","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1001\/jamapediatrics.2015.1305","article-title":"Epidemiologic trends in neonatal intensive care, 2007\u20132012","volume":"169","author":"Harrison","year":"2015","journal-title":"JAMA Pediatr."},{"key":"2026101308572849500_r2","doi-asserted-by":"crossref","first-page":"1121406","DOI":"10.3389\/fped.2023.1121406","article-title":"Risk factors for length of NICU stay of newborns: a systematic review","volume":"11","author":"Fu","year":"2023","journal-title":"Front Pediatr."},{"issue":"3","key":"2026101308572849500_r3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1624\/105812409X461199","article-title":"The parental experience of having an infant in the newborn intensive care unit","volume":"18","author":"Obeidat","year":"2009","journal-title":"J Perinat Educ."},{"issue":"4","key":"2026101308572849500_r4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.33425\/2639-9474.1273","article-title":"Exploring of parental stress and anxiety and its influencing factors in parents of premature infants","volume":"8","author":"Pan","year":"2024","journal-title":"Nur Primary Care."},{"issue":"8","key":"2026101308572849500_r5","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1038\/jp.2015.9","article-title":"Progress of PTSD symptoms following birth: a prospective study in mothers of high-risk infants","volume":"35","author":"Kim","year":"2015","journal-title":"J Perinatol."},{"issue":"1","key":"2026101308572849500_r6","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1186\/s12912-024-02458-y","article-title":"Parental stress and nurse-parent support in the neonatal intensive care unit: a cross-sectional study","volume":"23","author":"Konukbay","year":"2024","journal-title":"BMC Nurs."},{"issue":"8","key":"2026101308572849500_r7","first-page":"e66100","article-title":"Assessment of stress and anxiety in parents of neonates admitted in a tertiary care neonatal intensive care unit (NICU)","volume":"16","author":"Joshi","year":"2024","journal-title":"Cureus."},{"issue":"1","key":"2026101308572849500_r8","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12955-017-0602-3","article-title":"The impact of preterm birth <37\u00a0weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit","volume":"15","author":"Lakshmanan","year":"2017","journal-title":"Health Qual Life Outcomes."},{"issue":"9","key":"2026101308572849500_r9","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1097\/CHI.0b013e3181b21651","article-title":"Maternal depression and anxiety across the postpartum year and infant social engagement, fear regulation, and stress reactivity","volume":"48","author":"Feldman","year":"2009","journal-title":"J Am Acad Child Adolesc Psychiatry."},{"issue":"3","key":"2026101308572849500_r10","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1542\/peds.2003-1150-L","article-title":"Prevalence, stability, and predictors of clinically significant behavior problems in low birth weight children at 3, 5, and 8 years of age","volume":"114","author":"Gray","year":"2004","journal-title":"Pediatrics."},{"issue":"6","key":"2026101308572849500_r11","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1038\/s41390-024-03599-1","article-title":"Psychological distress in the neonatal intensive care unit: a meta-review","volume":"96","author":"van Wyk","year":"2024","journal-title":"Pediatr Res."},{"issue":"2","key":"2026101308572849500_r12","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00737-014-0445-4","article-title":"Postpartum bonding: the role of perinatal depression, anxiety and maternal-fetal bonding during pregnancy","volume":"18","author":"Dubber","year":"2015","journal-title":"Arch Womens Ment Health."},{"issue":"2","key":"2026101308572849500_r13","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/j.1600-0412.2011.01304.x","article-title":"The effects of preterm birth on mother-infant interaction and attachment during the infant\u2019s first two years","volume":"91","author":"Korja","year":"2012","journal-title":"Acta Obstet Gynecol Scand."},{"issue":"3","key":"2026101308572849500_r14","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/02646838.2019.1695041","article-title":"Maternal depression, anxiety, stress, and maternal-infant attachment in the neonatal intensive care unit","volume":"38","author":"Bonacquisti","year":"2020","journal-title":"J Reprod Infant Psychol."},{"key":"2026101308572849500_r15","doi-asserted-by":"crossref","first-page":"591359","DOI":"10.1155\/2009\/591359","article-title":"Maternal psychological problems associated with neonatal intensive care admission","volume":"2009","author":"Yurdakul","year":"2009","journal-title":"Int J Pediatr."},{"issue":"2","key":"2026101308572849500_r16","doi-asserted-by":"crossref","first-page":"104","DOI":"10.3345\/cep.2023.00486","article-title":"Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis","volume":"67","author":"Shetty","year":"2024","journal-title":"Clin Exp Pediatr."},{"issue":"1","key":"2026101308572849500_r17","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1186\/s12884-024-06383-5","article-title":"Factors associated with posttraumatic stress and anxiety among the parents of babies admitted to neonatal care: a systematic review","volume":"24","author":"Malouf","year":"2024","journal-title":"BMC Pregnancy Childbirth."},{"key":"2026101308572849500_r18","doi-asserted-by":"crossref","first-page":"101233","DOI":"10.1016\/j.eclinm.2021.101233","article-title":"Prevalence of anxiety and post-traumatic stress (PTS) among the parents of babies admitted to neonatal units: a systematic review and meta-analysis","volume":"43","author":"Malouf","year":"2021","journal-title":"EClinicalMedicine."},{"issue":"4","key":"2026101308572849500_r19","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/00006199-198807000-00008","article-title":"Anxiety, depression, and hostility in mothers of preterm infants","volume":"37","author":"Brooten","year":"1988","journal-title":"Nurs Res."},{"issue":"1","key":"2026101308572849500_r20","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/j.1741-3729.2003.00012.x","article-title":"Parental anxiety following discharge from hospital of their very low birth weight infants","volume":"52","author":"Auslander","year":"2003","journal-title":"Fam Relat."},{"issue":"1","key":"2026101308572849500_r21","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1080\/14616734.2019.1589070","article-title":"Father involvement, father-child relationship, and attachment in the early years","volume":"22","author":"Cabrera","year":"2020","journal-title":"Attach Hum Dev."},{"issue":"9","key":"2026101308572849500_r22","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/jamapediatrics.2016.0810","article-title":"Evolution of depression and anxiety symptoms in parents of very preterm infants during the newborn period","volume":"170","author":"Pace","year":"2016","journal-title":"JAMA Pediatr."},{"issue":"1","key":"2026101308572849500_r23","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s40746-018-0112-5","article-title":"NICU hospitalization: long-term implications on parenting and child behaviors","volume":"4","author":"Lean","year":"2018","journal-title":"Curr Treat Options Pediatr."},{"issue":"2","key":"2026101308572849500_r24","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1136\/adc.74.2.115","article-title":"The effect of a child\u2019s disability on mother\u2019s mental health","volume":"74","author":"Lambrenos","year":"1996","journal-title":"Arch Dis Child."},{"key":"2026101308572849500_r25","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1017\/S1463423619000021","article-title":"Stress and feelings in mothers and fathers in NICU: identifying risk factors for early interventions","volume":"20","author":"Ionio","year":"2019","journal-title":"Prim Health Care Res Dev."},{"key":"2026101308572849500_r26","doi-asserted-by":"crossref","first-page":"23779608241231172","DOI":"10.1177\/23779608241231172","article-title":"The stress levels of premature infants\u2019 parents and related factors in NICU","volume":"10","author":"Hendy","year":"2024","journal-title":"SAGE Open Nurs."},{"issue":"5","key":"2026101308572849500_r27","doi-asserted-by":"crossref","first-page":"e009699","DOI":"10.1136\/bmjopen-2015-009699","article-title":"A Norwegian prospective study of preterm mother-infant interactions at 6 and 18\u00a0months and the impact of maternal mental health problems, pregnancy and birth complications","volume":"6","author":"Misund","year":"2016","journal-title":"BMJ Open."},{"issue":"6","key":"2026101308572849500_r28","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1111\/j.1552-6909.2007.00186.x","article-title":"Mothers and fathers of very low-birthweight infants: similarities and differences in the first year after birth","volume":"36","author":"Feeley","year":"2007","journal-title":"J Obstet Gynecol Neonatal Nurs."},{"issue":"2","key":"2026101308572849500_r29","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1017\/S1138741600004601","article-title":"Maternal anxiety and depression and development of prematurely born infants in the first year of life","volume":"11","author":"Carvalho","year":"2008","journal-title":"Span J Psychol."},{"key":"2026101308572849500_r30","volume-title":"Manual for the State-Trait Anxiety Inventory","author":"Spielberger","year":"1983"},{"issue":"2","key":"2026101308572849500_r31","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1002\/1097-4679(197604)32:2<276::AID-JCLP2270320215>3.0.CO;2-G","article-title":"A reliability and validity study of the State-Trait Anxiety Inventory","volume":"32","author":"Metzger","year":"1976","journal-title":"J Clin Psychol."},{"issue":"7","key":"2026101308572849500_r32","doi-asserted-by":"crossref","first-page":"e306","DOI":"10.1111\/apa.12975","article-title":"Maternal psychological distress and visitation to the neonatal intensive care unit","volume":"104","author":"Greene","year":"2015","journal-title":"Acta Paediatr."},{"issue":"3","key":"2026101308572849500_r33","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1038\/jp.2012.75","article-title":"Identifying mothers of very preterm infants at-risk for postpartum depression and anxiety before discharge","volume":"33","author":"Rogers","year":"2013","journal-title":"J Perinatol."},{"issue":"2","key":"2026101308572849500_r34","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.1464-0597.1984.tb01432.x","article-title":"The development and validation of the Dutch form of the Test Anxiety Inventory2","volume":"33","author":"van der Ploeg","year":"1984","journal-title":"Appl Psychol."},{"issue":"1","key":"2026101308572849500_r35","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.earlhumdev.2008.06.010","article-title":"Persistent maternal anxiety affects the interaction between mothers and their very low birthweight children at 24\u00a0months","volume":"85","author":"Zelkowitz","year":"2009","journal-title":"Early Hum Dev."},{"issue":"12","key":"2026101308572849500_r36","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/S2215-0366(25)00197-X","article-title":"Postpartum anxiety: a state-of-the-art review","volume":"12","author":"Feldman","year":"2025","journal-title":"Lancet Psychiatry."},{"issue":"7","key":"2026101308572849500_r37","doi-asserted-by":"crossref","first-page":"e00497","DOI":"10.1002\/brb3.497","article-title":"A systematic review of reviews on the prevalence of anxiety disorders in adult populations","volume":"6","author":"Remes","year":"2016","journal-title":"Brain Behav."},{"issue":"2","key":"2026101308572849500_r38","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1177\/070674370605100206","article-title":"Prevalence and incidence studies of anxiety disorders: a systematic review of the literature","volume":"51","author":"Somers","year":"2006","journal-title":"Can J Psychiatry."},{"issue":"1","key":"2026101308572849500_r39","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12904-023-01183-8","article-title":"Context of a neonatal death affects parental perception of end-of-life care, anxiety and depression in the first year of bereavement","volume":"22","author":"Cambonie","year":"2023","journal-title":"BMC Palliat Care."},{"issue":"5 Pt 1","key":"2026101308572849500_r40","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1542\/peds.96.5.933","article-title":"Psychological changes in parents eight months after the loss of an infant from stillbirth, neonatal death, or sudden infant death syndrome--a longitudinal study","volume":"96","author":"Vance","year":"1995","journal-title":"Pediatrics."},{"issue":"4","key":"2026101308572849500_r41","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jnn.2016.03.001","article-title":"Losing one twin in the NICU \u2013 a case study of the parental experience","volume":"22","author":"Aagaard","year":"2016","journal-title":"J Neonatal Nurs."},{"issue":"4","key":"2026101308572849500_r42","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.arcped.2013.01.010","article-title":"Experience of parents after the loss of a newborn twin in the NICU: a qualitative study 3 years after the death","volume":"20","author":"Vasilescu","year":"2013","journal-title":"Arch Pediatr."},{"issue":"1","key":"2026101308572849500_r43","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00737-023-01291-7","article-title":"Twin pregnancy and severe maternal mental illness: a Canadian population-based cohort study","volume":"26","author":"Lapinsky","year":"2023","journal-title":"Arch Womens Ment Health."},{"key":"2026101308572849500_r44","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jad.2016.01.016","article-title":"Postpartum anxiety and adjustment disorders in parents of infants with very low birth weight: cross-sectional results from a controlled multicentre cohort study","volume":"194","author":"Helle","year":"2016","journal-title":"J Affect Disord."},{"issue":"4","key":"2026101308572849500_r45","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/acps.12622","article-title":"Factors associated with postpartum psychiatric admission in a population-based cohort of women with schizophrenia","volume":"134","author":"Vigod","year":"2016","journal-title":"Acta Psychiatr Scand."},{"issue":"1","key":"2026101308572849500_r46","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1186\/1471-2393-14-191","article-title":"The influence of women\u2019s preferences and actual mode of delivery on post-traumatic stress symptoms following childbirth: a population-based, longitudinal study","volume":"14","author":"Garthus-Niegel","year":"2014","journal-title":"BMC Pregnancy Childbirth."},{"key":"2026101308572849500_r47","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.midw.2017.09.016","article-title":"Stress in fathers in the perinatal period: a systematic review","volume":"55","author":"Philpott","year":"2017","journal-title":"Midwifery."},{"issue":"3","key":"2026101308572849500_r48","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1002\/imhj.21902","article-title":"Development and nationwide implementation of a postdischarge responsive parenting intervention program for very preterm born children: the TOP program","volume":"42","author":"Jeukens-Visser","year":"2021","journal-title":"Infant Ment Health J."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-074834\/1944287\/pediatrics.2025074834.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-074834\/1944287\/pediatrics.2025074834.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:57:37Z","timestamp":1791896257000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/158\/2\/e2025074834\/208234\/Parental-Anxiety-Trajectories-2-Years-After-NICU"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":48,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,7,14]]},"published-print":{"date-parts":[[2026,8,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2025-074834","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"article-number":"e2025074834"}}