***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Evaluations of evidence -based , easily accessible , psychological interventions to improve maternal mental health following very preterm birth are scarce . This study investigated the efficacy and acceptability of the expressive writing paradigm for mothers of very preterm infants . The level of maternal posttraumatic stress and depressive symptoms was the primary outcome . Participants were 67 mothers of very preterm babies who were r and omly allocated into the intervention ( expressive writing ; n = 33 ) or control group ( treatment-as-usual ; n = 32 ) when their infant was aged 3 months ( corrected age , CA ) . Measurements were taken at 3 months ( pre-intervention ) , 4 months ( post-intervention ) , and 6 months CA ( follow-up ) . Results showed reduced maternal posttraumatic stress ( d = 0.42 ) , depressive symptoms ( d = 0.67 ) , and an improved mental health status ( d = 1.20 ) in the intervention group , which were maintained at follow-up . Expressive writing is a brief , cost-effective , and acceptable therapeutic approach that could be offered as part of the NICU care BACKGROUND Preterm birth and survival rates of very low birth-weight ( VLBW : < 1.500 g ) infants have increased . Although new parents are frequently affected by depressive symptoms , little is known about prevalence , risk , and predictors of parental postpartum depression ( PPD ) following VLBW birth . Furthermore , most studies assessing PPD in parents of preterm children relied on self-report only . METHODS As part of the HaFEn cohort- study , data from the index groups of parents with VLBW infants and the control group of parents with term infants were cross-sectionally analysed . Families were recruited at the three largest centres of perinatal medical care in Hamburg , Germany . PPD was evaluated one month postpartum using st and ardized question naires and clinical interviews .  Socioeconomic status , social support , risks during pregnancy , and psychiatric lifetime diagnoses were also assessed . A multiple r and om coefficient model was used to examine predictors of PPD in both parents simultaneously . RESULTS 230 mothers and 173 fathers were included . Depending on the measure , the risk of being postnatally depressed was 4 to 18 times higher in mothers and 3 to 9 times higher in fathers from the index group . The most relevant risk factor for PPD was the birth of a VLBW infant , followed by female sex , lifetime psychiatric disorder , and low social support . LIMITATIONS Results presented here , are based on cross sectional data . Therefore no temporal relationships can be established . CONCLUSIONS Our findings highlight the importance of early screening for PPD in both parents of VLBW infants . Factors contributing to developing depression should also be considered in neonatal care BACKGROUND Both preterm delivery and survival rates of very low birth weight ( VLBW : < 1500 g ) infants are increasing . To date , the focus on studies about postpartum mental health after preterm birth has been on depression and on women . There is a paucity of research regarding prevalence , risks , and predictors of postpartum anxiety in parents after VLBW birth . METHODS Parents with VLBW infants and parents with term infants were recruited into the longitudinal HaFEn- study at the three largest centers of perinatal care in Hamburg , Germany . State anxiety was assessed with the  State-Trait-Anxiety Inventory and anxiety and adjustment disorders with a clinical interview one month postpartum .  Psychiatric lifetime diagnoses , social support , trait anxiety , stress during birth , socioeconomic status , risks during pregnancy , and mode of delivery were also evaluated . To examine predictors of postpartum state anxiety in both parents simultaneously a multiple r and om coefficient model was used . RESULTS 230 mothers and 173 fathers were included . The risk for minor/major anxiety symptoms and adjustment disorders was higher in parents with VLBW infants compared to the term group . 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 . LIMITATIONS Data reported here are cross-sectional . Thus , temporal relationships can not be established . CONCLUSIONS Our results emphasize the importance of early screening for postpartum anxiety in both parents with VLBW infants Objective : Mothers of preterm infants in a hospital neonatal intensive care unit ( NICU ) are at risk for clinical ly significant depression and anxiety , but for these women their own treatment is likely a secondary priority . This study evaluated the feasibility , acceptability and effectiveness of an evidence -based , nurse-delivered , on-site depression treatment : listening visits ( LVs ) . Study Design : Therapeutic LVs were delivered on site to 23 distressed mothers of NICU infants . The intervention was conducted by a neonatal nurse practitioner and the outcome was examined in an open-trial , pre-post evaluation . Result : A part-time nurse practitioner delivered six LVs to each participant within a 1-month time frame . LVs were associated with significantly improved mood and well-being in mothers . The majority of eligible women took advantage of LVs and felt satisfied with their care . Conclusion : This open trial provides ‘ proof-of-concept ’ , with results that warrant further evaluation in a multisite r and omized controlled trial Background : Underst and ing the processes through which interventions work for mothers of premature infants is necessary for the advancement of science and the translation of efficacious interventions into clinical practice setting s. Objective : To test a theoretical model examining the processes through which an educational-behavioral intervention program ( Creating Opportunities for Parent Empowerment [ COPE ] ) influences mothers ' anxiety and depression 2 months after discharge of their premature infants from the neonatal intensive care unit ( NICU ) . Methods : A secondary analysis was conducted using data from a r and omized controlled trial with 246 mothers of low-birth-weight preterm infants who were assigned r and omly to COPE or placebo control conditions .  Measures included mothers ' stress in the NICU , mothers ' anxiety and depression , and mothers ' beliefs about their infants and their role . Observers blind to study group condition also rated the quality of mother- infant interaction in the NICU . Results : Structural equation modeling suggested that the model tested provided a reasonable fit to the data , χ2(64 ) = 97.67 , p = .004 , root mean square error of approximation = .046 , comparative fit index = .97 . Participation in COPE was both directly and indirectly , via associations with increased maternal beliefs and less maternal depression and anxiety in the NICU , related to mothers ' decreased posthospital depression and anxiety . Participation in the COPE program also was associated with higher mother- infant interaction scores . Conclusion : Implementation of COPE could lessen postdischarge maternal anxiety and depression , which may improve outcomes for both mothers and preterm infants There are no established screening criteria to help identify mothers of premature infants who are at risk for symptoms of emotional distress . The current study , using data obtained from recruitment and screening in preparation for a r and omized controlled trial , aim ed to identify potential risk factors associated with symptoms of depression , anxiety and posttraumatic stress in a sample of mothers with premature infants hospitalized in a neonatal intensive care unit . One hundred , thirty-five mothers of preterm infants born at 26–34 weeks of gestation completed three self-report measures : the Stanford Acute Stress Reaction Question naire , the Beck Depression Inventory ( 2nd ed . ) , and the Beck Anxiety Inventory  to determine their eligibility for inclusion in a treatment intervention study based on clinical cut-off scores for each measure . Maternal sociodemographic measures , including race , ethnicity , age , maternal pregnancy history , and measures of infant medical severity were not helpful in differentiating mothers who screened positive on one or more of the measures from those who screened negative . Programs to screen parents of premature infants for the presence of symptoms of posttraumatic stress , anxiety , and depression will need to adopt universal screening rather than profiling of potential high risk parents based on their sociodemographic characteristics or measures of their infant 's medical severity PURPOSE : To determine whether significant symptoms of acute stress disorder ( ASD ) are present in mothers of premature infants in the neonatal intensive care unit ( NICU ) . SUBJECTS : Forty mothers of premature infants born less than 33 weeks and admitted into NICU . DESIGN : Prospect i ve , cohort , within-subjects . METHODS : Mothers completed the Stanford Acute Stress Reaction Question naire , Edinburgh Postnatal Depression Scale , and the Acute Stress Disorder Interview to explore the number and severity of stress-related symptoms at 2 separate time periods , 7 to 10 days after birth , and 1 month after birth . RESULTS : Twenty-eight percent of the mothers met diagnostic criteria of ASD at 7 to 10 days after birth , and at 1 month after birth ASD symptoms persisted . The majority of the mothers described premature birth as a traumatic stressor . The most commonly met criteria were dissociation and anxiety . Significant symptoms of depression were found in 43 % of mothers and persisted 1 month after birth . Rates of depression and moderate to severe symptoms of ASD were significantly related in mothers at 1 week and at 1 month after birth . CONCLUSIONS : The premature birth experience is traumatic for mothers and may lead to various emotional responses including stress-related symptoms such as depression and /or ASD . Mothers with significant symptoms of depression and those with symptoms of stress seem to be more at risk for developing symptoms of ASD OBJECTIVE . Although low birth weight premature infants and parents are at high risk for adverse health outcomes , there is a paucity of studies that test early NICU interventions with parents to prevent the development of negative parent-infant interaction trajectories and to reduce hospital length of stay . Our objective was to evaluate the efficacy of an educational-behavioral intervention program ( ie , Creating Opportunities for Parent Empowerment ) that was design ed to enhance parent-infant interactions and parent mental health outcomes for the ultimate purpose of improving child developmental and behavior outcomes . DESIGN , SETTING , AND PARTICIPANTS . A r and omized , controlled trial was conducted with 260 families with preterm infants from 2001 to 2004 in 2 NICUs in the northeast United States . Parents completed self-administered instruments during hospitalization , within 7 days after infant discharge , and at 2 months ' corrected age . Blinded observers rated parent-infant interactions in the NICU . INTERVENTION . All participants received 4 intervention sessions of audiotaped and written material s. Parents in the Creating Opportunities for Parent Empowerment program received information and behavioral activities about the appearance and behavioral characteristics of preterm infants and how best to parent them . The comparison intervention contained information regarding hospital services and policies . MAIN OUTCOME MEASURES . Parental stress , depression , anxiety , and beliefs ; parent-infant interaction during the NICU stay ; NICU length of stay ; and total hospitalization were measured . RESULTS . Mothers in the Creating Opportunities for Parent Empowerment program reported significantly less stress in the NICU and less depression and anxiety at 2 months ' corrected infant age than did comparison mothers . Blinded observers rated mothers and fathers in the Creating Opportunities for Parent Empowerment program as more positive in interactions with their infants . Mothers and fathers also reported stronger beliefs about their parental role and what behaviors and characteristics to expect of their infants during hospitalization . Infants in the Creating Opportunities for Parent Empowerment program had a 3.8-day shorter NICU length of stay ( mean : 31.86 vs 35.63 days ) and 3.9-day shorter total hospital length of stay ( mean : 35.29 vs 39.19 days ) than did comparison infants . CONCLUSIONS . A reproducible educational-behavioral intervention program for parents that commences early in the NICU can improve parent mental health outcomes , enhance parent-infant interaction , and reduce hospital length of stay OBJECTIVE To evaluate the psychological functioning in parents whose infants were admitted to a neonatal intensive care unit ( NICU ) over the first 2 years of the infant 's life . METHODS Prospect i ve 2-year follow-up study of a r and om selection of NICU and control families . At baseline , 9 months , and 2 years , all parents received a clinical interview . Infants underwent a pediatric examination and Bayley II neurodevelopmental assessment at 2 years . Psychological distress is defined as having one or more of the following criteria : any psychiatric diagnosis on the Mini-International Neuropsychiatric Interview at 2 years ; Edinburgh Post Natal Depression Scale score more than 12.5 at 2 years ; Hospital Anxiety and Depression Scale score more than 11.0 at 2 years , receiving treatment with antidepressants/psychotherapy/counselling over the previous 15 months . RESULTS Overall , 300 families of infants admitted to a NICU and 120 control families were approached to take part in the study . There was no difference in psychological distress in NICU parents ( 30.8 % ) vs control parents ( 28.2 % ) . In fathers , there was no relationship between psychological distress and infant development measured using the Bayley II . In mothers , there was a relationship between psychological distress and the child 's mental development , which was most significant in infants with severe developmental delay . CONCLUSIONS There are no significant long-term negative psychological effects on parents whose infants were admitted to a NICU . Should interventions for parents be offered , they should focus on mothers whose infants are likely to have significant mental 
    Output:
    
RESULTS : Common socioeconomic factors and infant and parent characteristics may place parents at a greater risk for developing distress .