Prevalence of and factors associated with postnatal depression and anxiety among parents of preterm infants: A systematic review and meta-analysis
Abstract
Background This study aimed to determine the prevalence of and factors associated with postpartum depression and anxiety among mothers and fathers of preterm infants and to examine the relationships between maternal and paternal symptoms.Methods Six electronic databases were searched to identify eligible studies reporting parental depression and anxiety within 1 year postpartum. Data were extracted for a random-effects meta-analysis to estimate the prevalence with 95 % confidence intervals (CIs). Subgroup and meta-regression analyses were conducted to analyze associations between study characteristics and prevalence estimates.Results In total, 79 studies were included. The meta-analysis of studies on mothers generated estimates of prevalence for depression (29.2 %, 95 % CI, 21.8 %-37.9 %) and anxiety (37.7 %, 95 % CI, 24.1 %-53.6 %). The meta-analysis of fathers indicated a pooled depression prevalence of 17.4 % (95 % CI, 12.5 %-23.8 %) and an anxiety estimate of 18.3 % (95 % CI, 8.1 %-36.3 %). Assessment time points and methods as well as the geographic continent in which the study was conducted were significant moderators of depression and anxiety. Significant inter-correlations were found between mothers' and fathers' depression and anxiety symptoms (p < 0.05).Limitations Limited data from specific geographic continents, including Africa and Asia.Conclusions Prevalence of depression and anxiety among preterm infants' parents was high, highlighting the need for early psychological screening and assessment. Further research is required to improve services that focus on parents' postpartum psychological needs in the family context.
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Following preterm birth, about 17% of fathers develop postpartum depression, compared to 8.75% prevalence typically reported after term birth.
“Following PB, about 17% of fathers develop postpartum depression (PPD) [19], compared to 8.75% prevalence typically reported after term birth (TB) [20].”
From Fathers at risk: Effects of threatened and actual preterm birth on the course of paternal peripartum depression and anxiety (2026) · cites this paper as [19]
Approximately 12-25% of fathers report antepartum anxiety symptoms, and around 18% experience postpartum anxiety.
“Approximately 12–25% of fathers report antepartum anxiety symptoms [17,18], and around 18% experience postpartum anxiety [19].”
From Fathers at risk: Effects of threatened and actual preterm birth on the course of paternal peripartum depression and anxiety (2026) · cites this paper as [19]
Accumulating evidence suggests that maternal and paternal depressive, anxiety, and stress symptoms are interdependent.
“This represents a limitation, as accumulating evidence suggests that maternal and paternal depressive, anxiety, and stress symptoms are interdependent [19,56–58].”
From Fathers at risk: Effects of threatened and actual preterm birth on the course of paternal peripartum depression and anxiety (2026) · cites this paper as [19]
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DEPRESSION AMONG MOTHERS WITH PRETERM INFANTS AND THEIR STRESS-COPING STRATEGIES
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Psychological distress in the neonatal intensive care unit: a meta-review
van Wyk, L., Majiza, A. P., Ely, C. S. E., & Singer, L. T. (2024) · Pediatric Research · doi:10.1038/s41390-024-03599-1 · Cited by 60 · see citing works
Prevalence of depression in melasma: a systematic review and meta-analysis
Chen, W., Wan, Y., Sun, Y., Gao, C., & Li, J. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1276906 · Cited by 29 · see citing works
Rosa, V. L. L., Oddo-Sommerfeld, S., Schermelleh-Engel, K., & Commodari, E. (2024) · Current Psychology · doi:10.1007/s12144-024-06603-3 · Cited by 15 · see citing works
“…post-traumatic stress, and low well-being are much higher than those known in the postpartum period in general and even comparable to the prevalence known for risk groups of mothers with, e.g., preterm birth or preg - nancy/delivery complications (Nguyen et al., 2023 ; Som - merlad et al., 2021 ).”
Rodrigues, S. M., Shin, S. S., Pinto, M. D., Bounds, D. T., Terry, J., & Burton, C. W. (2024) · Advances in Neonatal Care · doi:10.1097/anc.0000000000001139 · Cited by 10 · see citing works
“Our study sample reported lower rates of depression and anxiety than those reported by Nguyen et al 2 in their recent systematic review and meta-analysis of prevalence and factors associated with postnatal depression and anxiety among parents of preterm infants.”
ResultThomson, G., McNally, L., & Nowland, R. A. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-06713-7 · Cited by 10 · see citing works
Rodrigues, S. M., Bounds, D. T., Terry, J. R., Pinto, M. D., Shin, S. S., & Burton, C. W. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2250000 · Cited by 7 · see citing works
“…of research has established that infant NICU hospitalization increases maternal risk for psychological distress, including greater anxiety and stress, depression, and both acute and post-traumatic stress disorders (ASD and PTSD) (McKeown et al., 2023; Nguyen et al., 2023; Staver et al., 2021).”
BackgroundNdjomo, G. C., Njiengwe, E. F., Moudze, B., Guifo, O., & Blairy, S. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07507-1 · Cited by 9 · see citing works
“These results are consistent with previous studies [8, 12, 15].”
Matvienko‐Sikar, K., van Dijk, W., Dockray, S., & Leahy‐Warren, P. (2025) · Women and Birth · doi:10.1016/j.wombi.2025.101941 · Cited by 6 · see citing works
Barnett, K. A. I., Sanders, A., Kyser, R., Babagoli, B., Goyal, D., & Le, H. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22101592 · Cited by 7 · see citing works
“Results demonstrated that both interventions were equally effective at decreasing depressive symptoms, although parents were less likely to review all the material on the tablet compared to the paper handouts [13].”
InfluentialThe effect of paternal anxiety on mother-infant bonding in neonatal intensive care
Ettenberger, M., Bieleninik, Ł., Stordal, A. S., & Ghetti, C. M. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-06179-z · Cited by 6 · see citing works
“A very recent meta-analysis on mental health of parents of preterm infants showed a clear intercorrelation between both depression and anxiety symptoms of mothers and fathers and particularly positive correlations between maternal and paternal depression and maternal and paternal anxiety [30].”
BackgroundAddressing depression in parents of neonates: the critical need for integrated care in the NICU
Syed, F. A., Mittal, S., Thakur, M., Kumar, L., & Yadav, K. (2024) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2024.2356033 · Cited by 5 · see citing works
“The establishment of policies to improve family-centered care in neonatal intensive care will be impacted by these findings. nguyen et al. [16] Meta analysis review prevalence of anxiety (37.7”
InfluentialPrior COVID-19 Diagnosis, Severe Outcomes, and Long COVID among U.S. Adults, 2022
Nguyen, K. H., Bao, Y., Chen, S., Bednarczyk, R. A., Vasudevan, L., & Corlin, L. (2024) · Vaccines · doi:10.3390/vaccines12060669 · Cited by 5 · see citing works
“However, the prevalence of long COVID found in this study is similar to that found in other national U.S. household surveys [40–43].”
ResultXue, B., Wang, X., Tang, J., Lai, Y.-Q., Ma, D., Luo, L., Guan, Y., Redding, S. R., & Ouyang, Y. (2024) · Midwifery · doi:10.1016/j.midw.2024.104117 · Cited by 5 · see citing works
Pellegrino, J., Mundagowa, P. T., Sakyi, K. S., Owusu, P. G., Agbinko‐Djobalar, B., Larson, L. M., & Kanyangarara, M. (2024) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15998 · Cited by 4 · see citing works
A Compassion-Focused Approach to Support Parents After Preterm Birth
Lloyd-Collins, T. M., Fitzallen, G. C., & Kirby, J. N. (2025) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-025-00549-z · Cited by 3 · see citing works
“This co-occurrence of distress in families suggests that the mental health of both parents must be addressed simultaneously (Nguyen et al., 2023).”
Kerstis, B., Jönsson, P., Derwig, M., Nilsson, K. W., Hallström, I., & Lindeberg, S. (2025) · Child: Care, Health and Development · doi:10.1111/cch.70099 · Cited by 3 · see citing works
“Consistent with study results concerning levels of depressive symptoms and anxiety (Glasser and Lerner-Geva 2019; Hantsoo and Epperson 2017; Nguyen et al. 2023), studies demonstrate higher perinatal stress levels in mothers than in fathers (Challacombe et al. 2023; Hildingsson and Thomas 2014),…”
Rodrigues, S. M., Shin, S. S., Pinto, M. D., Bounds, D. T., Terry, J. R., & Burton, C. W. (2025) · Issues in Mental Health Nursing · doi:10.1080/01612840.2024.2433497 · Cited by 2 · see citing works
“It is well established that infant neonatal intensive care unit (NICU) hospitalization increases maternal risk for psychological distress (Beck & Woynar, 2017; Geller et al., 2018; McKeown et al., 2023; Nguyen et al., 2023; Roque et al., 2017; Staver et al., 2021).”
Nguyen, C. T. T., Trung, T. Q., Nguyen, A. T. L., Vu, H. T., Nguyen, L. T. K., Nguyen, T. M., & Kuo, S. (2025) · Midwifery · doi:10.1016/j.midw.2025.104443 · Cited by 2 · see citing works
Self-citationPoćwierz-Marciniak, I., Bieleninik, Ł., Cruz, J. B., Ardila, Y. M. B., Jassem-Bobowicz, J. M., Malaver, S. A. H., Díaz, A. M., Reina, N. N. M., de la Barrera, L. I. M., Gaona, A. J. C., et al. (2024) · Health Psychology Report · doi:10.5114/hpr/190886 · Cited by 2 · see citing works
“…to postpartum depression (de Paula Eduardo et al., 2019; Nguyen et al., 2023; Vigod et al., 2010), high levels of stress (Ionio et al., 2016; Singer et al., 1999), anxiety (Malouf et al., 2022; Nguyen et al., 2023), and post-traumatic stress disorder (Cook et al., 2018; Grekin & O’Hara, 2014).”
Backgroundİpar, N., Alper, E. N., Aydın, N. E., Aktaş, Ö., Kurt, Ö. M., & Baygül, A. (2025) · Gulhane Medical Journal · doi:10.4274/gulhane.galenos.2025.59023 · Cited by 2 · see citing works
Xu, F., Shi, L., & Gao, L. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i3.101748 · Cited by 2 · see citing works
Alikamali, M., Mohammad‐Alizadeh‐Charandabi, S., Mirghafourvand, M., Gharehbaghi, M. M., Rad, A. H., Fardiazar, Z., & Shahnazi, M. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-079526 · Cited by 1 · see citing works
Effects of Webcam Access to Preterm Infants in NICUs on Parental Psychological Strain
Mause, L., Hoffmann, J., Dresbach, T., Hagemeier, A., Hellmich, M., Kastor, K. L., Kuehne, B., Reimer, A., Willerscheidt, C., Scholten, N., et al. (2025) · Acta Paediatrica · doi:10.1111/apa.17588 · Cited by 1 · see citing works
Im Einklang – Rhythmus für Kind und Eltern
Hurst, N. (2025) · JuKiP - Ihr Fachmagazin für Gesundheits- und Kinderkrankenpflege · doi:10.1055/a-2693-7734 · Cited by 1 · see citing works
de Carvalho, F. S., van Dijk, M., Bouw, N., Swarte, R. M. C., Vliegen, N., & Dulfer, K. (2026) · Journal of Neonatal Nursing · doi:10.1016/j.jnn.2026.101925 · Cited by 1 · see citing works
Pernidaki, V., Schermelleh-Engel, K., Sommerlad, S., Louwen, F., & Oddo-Sommerfeld, S. (2026) · PLOS One · doi:10.1371/journal.pone.0356746
Ndjomo, G. C., Blairy, S., & Durieux, N. (2024) · JBI Evidence Synthesis · doi:10.11124/jbies-23-00250
Improving Maternal Depression Screening in the Neonatal Intensive Care Unit
McCabe, J. E., Henderson, L., Davila, R. C., & Segre, L. S. (2024) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000001001
Siew, J., Warreyn, P., Moerman, F., Lierde, T. V., Zanatta, A., & Roeyers, H. (2025) · Autism Research · doi:10.1002/aur.70067
Neda-Stepan, O., Giurgi-Oncu, C., Bosun, A., Nakhebi, O. A. S. A., Levai, C. M., Kalinovic, R., Bernad, B.-C., Gliga, M., Mihai, A., Neamțu, R., et al. (2025) · Medicina · doi:10.3390/medicina61071149
“A 2023 meta-analysis spanning 79 studies reported a pooled PPD prevalence of 29.2% in mothers of preterm infants versus 17.4% in fathers, emphasising prematurity as a substantial stressor [33].”
InfluentialConséquences psychiques maternelles de la prématurité et conséquences chez l’enfant
Muller, J. (2025) · Contraste · doi:10.3917/cont.062.0081
Fieß, A., Hartmann, A., Schuster, A. K.-G., Grabitz, S. D., Wackernagel, D., Urschitz, M. S., Tesarz, J., Beutel, M. E., Ernst, M., Mildenberger, E., et al. (2025) · Child Care Health and Development · doi:10.1111/cch.70170
“Many studies have shown that parents of individuals born preterm often struggle with mental health problems (Pace et al. 2016; Nguyen et al. 2023).”
Wang, S., Gao, M., Yang, Y., Sun, M., Zhang, D., Luo, Y., Wang, J., & Zheng, R. (2026) · Mindfulness · doi:10.1007/s12671-025-02746-x
Srichalerm, T., Phonyiam, R., & Kamkhoad, D. (2026) · JBI Evidence Synthesis · doi:10.11124/jbies-25-00324
Amzajerdi, A., Ahmadi, S., Pezaro, S., Abdi, F., Sarvi, F., & Keshavarz, M. (2026) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-08630-9
Динамика эмоционального состояния женщин после преждевременных и срочных родов: сравнительный анализ
Korgozha, M. A., Евмененко, А. О., Курдынко, Л. В., & Щурова, О. В. (2026) · Психиатрия психотерапия и клиническая психология · doi:10.34883/pi.2026.17.1.013
Chrzan‐Dętkoś, M., Murawska, N., & Łockiewicz, M. (2026) · Depression and Anxiety · doi:10.1155/da/5236584
“For anxiety, the signi fi cant predictors included all the above-mentioned variables, and additionally, giving birth during the COVID-19 pandemic, which may be associated with a high comorbidity of PPD and anxiety symptoms [67].”
Noonan, M., Fitzgibbon, V., Keyes, R., McCarthy, J., Bradshaw, C., Tighe, S. M., Atkinson, S., Connell, D. O., Byrt, H., Shanahan, M., et al. (2026) · Maternal and Child Nutrition · doi:10.1111/mcn.70193
“Elevated stress, anxiety and depression (Nguyen et al. 2023; Pace et al. 2016) can hinder transitions to parent-hood, breastmilk production, decision‐making, the sustainment of milk expression and the success of DFAB (Flacking et al. 2021; Schwab et al. 2024).”
REGULAÇÃO EMOCIONAL E SINTOMATOLOGIA PSIQUIÁTRICA DE MÃES DE NEONATOS INTERNADOS EM UMA MATERNIDADE
de Araújo, V. S., Oliveira, S. A. D. S., de Medeiros, M. T. B., Rodrigues, J. F. D. P. V., & Gadelha, M. J. N. (2026) · Psicologia e Saúde em Debate · doi:10.22289/2446-922x.v12a1a70
Beyond protective factors and normal IQ in preterm children: More executive disorders than expected
Cadeau, O., Muller, J., Guerra, A., Boscher, C., Frondas, A., Rozé, J., Flamant, C., Boquien, C., Simon, L., & Roy, A. (2026) · Journal of Neuropsychology · doi:10.1111/jnp.70065
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“Further characterization of parental mental health outcomes is therefore essential, as parental depression and anxiety symptoms have been linked to adverse neurodevelopmental and behavioral outcomes in children [15,16].”
Kahiri, A. M., Rahayu, D. S., Pambudi, Y. E., & Hartanto, A. P. (2026) · Journal of Neonatal Nursing · doi:10.1016/j.jnn.2026.101975
İncekar, M. Ç., Şavaşer, S., ÇIRLAK, A., & Keçeli, M. S. (2026) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2026.08.062
Bihua, Z. H. U., Lei, Y., Huan, Y. A. N. G., & Luo, Y. (2026) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2026.09.021
Eke, A. C., & Igbodike, E. P. (2026) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1080/14737167.2026.2738026
Lee, D., Lee, N. H., Kim, S., & Ko, E. J. (2026) · Children · doi:10.3390/children13101295
“This pattern is consistent with previous studies reporting decreases in psychological distress among parents of preterm infants over time [15,16].”
Ahmadiazad, A., Ali, M. S. M. N., Ali, H. F. A., Ibrahim, T. A., Abdalla, A. A., Elkhair, M. E., & Sreejith, A. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1934224
Wonner, N.-R., Schmidt-Riese, M. D., Pernidaki, V., Köhnlein, A., Sommerlad, S., Louwen, F., Schermelleh-Engel, K., & Oddo-Sommerfeld, S. (2026) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2026.2737404
Kobus, S., Klasen, N. J., Weinkoetz, A., Schneider, F., Felderhoff‐Müser, U., & Bruns, N. (2026) · Maternal Health Neonatology and Perinatology · doi:10.1186/s40748-026-00300-8
“Prospective studies report that over 70% experience clinically relevant symptoms of trauma, anxiety, or depression in the first weeks postpartum [19], with systematic reviews estimating that 25–40% develop significant depressive or PTSD symptoms following NICU hospitalization [20].”
InfluentialYe, X., Huang, D., Zhan, E., Yan, S., Chen, T., 孙建华, Zheng, T., & Lin, B. (2026) · Midwifery · doi:10.1016/j.midw.2026.105009
Alikamali, M., Shahnazi, M., Mirghafourvand, M., Mostafa-Gharehbaghi, M., Rad, A. H., Fardiazar, Z., & Mohammad‐Alizadeh‐Charandabi, S. (2026) · Health Promotion Perspectives · doi:10.34172/hpp.45313
- Authors
- Nguyen, C. T. T., Sandhi, A., Lee, G. T., Nguyen, L. T. K., & Kuo, S.-Y.
- Affiliations
- Hanoi Medical University (VN)
- Universitas Gadjah Mada (ID)
- Western University (CA)
- Taipei Medical University (TW)
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2023-02
- Volume
- 322
- Pages
- 235-248
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W4309411189
- Cited by
- 53
- References
- 123
- Citations by year
- 2026: 20 · 2025: 16 · 2024: 16 · 2023: 1
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science and Technology, Taiwan
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- postpartum depression, postpartum anxiety, preterm infants, maternal mental health, paternal mental health, prevalence, risk factors, psychological screening
- MeSH terms
- Anxiety, Female, Humans, Infant, Infant, Newborn, Infant, Premature, Mothers, Parents, Prevalence, Depression, Postpartum
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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