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Cytokines, Cortisol, Depression, Preterm, Salivary



  1. Howland, Lois C. DrPH, RN
  2. Pickler, Rita H. PhD, RN, PNP-BC, FAAN
  3. McCain, Nancy L. RN, DSN, FAAN
  4. Glaser, Dale PhD
  5. Lewis, Mary BSN, RNC


Purpose: To evaluate physiologic measures of stress with self-reported perceived stress and depressive symptoms among mothers of preterm babies currently hospitalized in an NICU.


Study Design and Methods: This was a cross-sectional, descriptive, single-visit study of 20 mothers of hospitalized preterm infants. Data collected included self-report behavioral measures and a brief structured interview. Biological data were available on 17 mothers. Data were analyzed using descriptive and inferential statistics.


Results: Mothers reported high levels of stress and depressive symptoms. Higher levels of stress and more depressive symptoms were associated with higher levels of certain serum cytokines, higher levels of waking and afternoon salivary cortisol, and abnormal diurnal patterns of salivary [alpha]-amylase.


Clinical Implications: A NICU admission is a stressful time for which families typically have not had the opportunity to prepare. Mothers with higher levels of stress and depressive symptoms may be at higher risk for poorer physical and mental health. This study highlights the high levels of stress and depressive symptoms that may be experienced by mothers of preterm infants, and suggests the potential value of developing effective strategies to target maternal psychological distress.