Quality of life among mothers of preterm newborns in a Malaysian neonatal intensive care unit


quality of life
mother of preterm newborn
maternal stress
neonatal intensive care unit

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Ong, S. L., Soh, K. L., Hussin, E. O. D. ., Japar, S., Soh, K. G., Vorasiha, P. ., & Daud, A. (2022). Quality of life among mothers of preterm newborns in a Malaysian neonatal intensive care unit. Belitung Nursing Journal, 8(2), 93–100. https://doi.org/10.33546/bnj.1872
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Accepted for publication: 2022-01-08
Peer reviewed: Yes

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Background: As Quality of Life (QoL) becomes progressively vital in health care services, its importance in mother and child health is of no exception too. Quality of life among mothers with a premature newborn is an issue that has led to growing concerns in the health care system. Yet, despite the knowledge about mother’s QoL being essential to family-centered planning on prematurity integrated healthcare, current evidence has been scant. 

Objective: To examine factors related to the QoL of mothers having preterm newborns hospitalized in the neonatal critical unit.

Methods: A non-probability convenience survey was used in a public hospital in Malaysia, covering 180 mothers whose preterm newborns were hospitalized into level III Neonatal Intensive Care Unit (NICU) through the completion of a 26-questions survey of the World Health Organization Quality of Life (WHOQOL-BREF) and the 26-questions of Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU). The data were analyzed using descriptive statistics, bivariate analysis, and Pearson correlation coefficients.

Result: The mean scores for mothers' quality of life were (M = 3.67, SD = 0.73) and maternal stress (M = 3.03, SD = 0.90) out of 5. A mother’s occupation was found to be the only factor associated with the quality of life among mothers who have preterm newborns admitted to the NICU. Furthermore, maternal role change was found to have a moderate negative relationship with the quality of life (r = 0.310, p = 0.05).

Conclusion: The findings of this study revealed that the main factors contributing to the mother’s QoL during their preterm newborns’ NICU admission were role change-related stress. Thus, to maintain a better QoL among this group of mothers during this traumatic period, a special nursing intervention program must be implemented immediately, right after the preterm newborns’ admission, to relieve the mothers’ stress which has been proven to have a direct effect on the mothers’ QoL. The study results will alert healthcare providers, particularly neonatal nurses, on the need to support mothers psychologically in terms of role change. This is to ensure a better quality of life among mothers whose newborns were admitted to the NICU.


Supporting Agencies

Postgraduate Research Fund (PPP) PG047‐2014B, University of Malaya, Malaysia


Copyright (c) 2022 Swee Leong Ong, Kim Lam Soh, Emni Omar Daw Hussin, Salimah Japar, Kim Geok Soh, Ponpun Vorasiha, Azlina Daud

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

No conflict of interest to disclose by the researchers.


The authors wish to widen our genuine appreciation to the Malaysian Ministry of Health, particularly the neonatal specialists and nurses in the Neonatal Intensive Care Unit, Hospital Sultanah Nur Zahirah, for their assistance shining our compilation process. We also wish to thank all the mothers who agreed to spend their time participating in this project. Thank you to the Postgraduate Research Fund of University Malaya, Malaysia. Lastly, we wish to convey our greatest appreciation to our collaborators for their countless support. This study would not be possible without their help.

Authors’ Contributions

Study design: OSL, SKL, EH, SJ, PV; Data collection: OSL, SKL, SKG, AZ; Data analysis: OSL, EH, SKL, SJ; Manuscript writing: OSL, SKL, EH, PV, SKG; Critical revisions for important intellectual content: OSL, SKL, EH. All authors agreed with the final version of the article to be published.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


Ali, N. S., Ali, B. S., & Azam, I. S. (2009). Post partum anxiety and depression in peri-urban communities of Karachi, Pakistan: A quasi-experimental study. BMC Public Health, 9(1), 1-10. https://doi.org/10.1186/1471-2458-9-384

Amorim, M., Alves, E., Kelly-Irving, M., Ribeiro, A. I., & Silva, S. (2018). Quality of life of parents of very preterm infants 4 months after birth: A mixed methods study. Health and Quality of Life Outcomes, 16(1), 1-12. https://doi.org/10.1186/s12955-018-1011-y

Bahrami, N., Simbar, M., & Bahrami, S. (2013). The effect of prenatal education on mother’s quality of life during first year postpartum among Iranian women: A randomized controlled trial. International Journal of Fertility & Sterility, 7(3), 169-174.

Carr, A. J., & Higginson, I. J. (2001). Are quality of life measures patient centred? BMJ, 322(7298), 1357-1360. https://doi.org/10.1136/bmj.322.7298.1357

Eiser, C., Eiser, J. R., Mayhew, A. G., & Gibson, A. T. (2005). Parenting the premature infant: Balancing vulnerability and quality of life. Journal of Child Psychology and Psychiatry, 46(11), 1169-1177. https://doi.org/10.1111/j.1469-7610.2005.00415.x

Fabiyi, C., Rankin, K., Norr, K., Shapiro, N., & White-Traut, R. (2012). Anxiety among Black and Latina mothers of premature infants at social-environmental risk. Newborn and Infant Nursing Reviews, 12(3), 132-140. https://doi.org/10.1053/j.nainr.2012.06.004

Franz, C. (2016). Financial empowerment and health related quality of life in family scholar house participants. Journal of Financial Therapy, 7(1), 4. https://doi.org/10.4148/1944-9771.1099

Gulamani, S. S., Premji, S., Kanji, Z., & Azam, S. I. (2013). Preterm birth a risk factor for postpartum depression in Pakistani women. Open Journal of Depression, 2(4), 77-81.

Henderson, J., Carson, C., & Redshaw, M. (2016). Impact of preterm birth on maternal well-being and women's perceptions of their baby: A population-based survey. BMJ Open, 6(10), e012676. https://doi.org/10.1136/bmjopen-2016-012676

Hill, P. D., & Aldag, J. C. (2007). Maternal perceived quality of life following childbirth. Journal of Obstetric, Gynecologic & Neonatal Nursing, 36(4), 328-334. https://doi.org/10.1111/j.1552-6909.2007.00164.x

Howe, T.-H., Sheu, C.-F., Wang, T.-N., & Hsu, Y.-W. (2014). Parenting stress in families with very low birth weight preterm infants in early infancy. Research in Developmental Disabilities, 35(7), 1748-1756. https://doi.org/10.1016/j.ridd.2014.02.015

Huang, K., Tao, F., Liu, L., & Wu, X. (2012). Does delivery mode affect women’s postpartum quality of life in rural China? Journal of Clinical Nursing, 21(11‐12), 1534-1543. https://doi.org/10.1111/j.1365-2702.2011.03941.x

Ismail, R., Azlan, H. A. N., & Yusoff, F. (2015). Assessing the relationship between quality of life and marital satisfaction among Malaysian married couples. e-Bangi: Journal of Social Sciences and Humanities, 12(3), 65-71.

Kaaresen, P. I., Rønning, J. A., Tunby, J., Nordhov, S. M., Ulvund, S. E., & Dahl, L. B. (2008). A randomized controlled trial of an early intervention program in low birth weight children: Outcome at 2 years. Early Human Development, 84(3), 201-209. https://doi.org/10.1016/j.earlhumdev.2007.07.003

Lau, Y. (2013). The effect of maternal stress and health-related quality of life on birth outcomes among Macao Chinese pregnant women. The Journal of Perinatal & Neonatal Nursing, 27(1), 14-24. https://doi.org/10.1097/JPN.0b013e31824473b9

Lee, G. K., Lopata, C., Volker, M. A., Thomeer, M. L., Nida, R. E., Toomey, J. A., Chow, S. Y., & Smerbeck, A. M. (2009). Health-related quality of life of parents of children with high-functioning autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 24(4), 227-239. https://doi.org/10.1177%2F1088357609347371

Lee, S.-Y., & Kimble, L. P. (2009). Impaired sleep and well-being in mothers with low-birth-weight infants. Journal of Obstetric, Gynecologic & Neonatal Nursing, 38(6), 676-685. https://doi.org/10.1111/j.1552-6909.2009.01064.x

Miles, M. S., Funk, S. G., & Carlson, J. (1993). Parental Stressor Scale: neonatal intensive care unit. Nursing Research, 42(3), 148-152. https://doi.org/10.1097/00006199-199305000-00005

Mokhtar, N., Husniyah, A. R., Sabri, M. F., & Talib, M. A. (2015). Financial well-being among public employees in Malaysia: A preliminary study. Asian Social Science, 11(18), 49-54. http://dx.doi.org/10.5539/ass.v11n18p49

Mortazavi, F., Mousavi, S. A., Chaman, R., & Khosravi, A. (2014). Maternal quality of life during the transition to motherhood. Iranian Red Crescent Medical Journal, 16(5), e8443. https://dx.doi.org/10.5812%2Fircmj.8443

Noy, A., Taubman–Ben‐Ari, O., & Kuint, J. (2015). Well‐being and personal growth in mothers of full‐term and pre‐term singletons and twins. Stress and Health, 31(5), 365-372. https://doi.org/10.1002/smi.2560

Ong, S. L., Abdullah, K. L., Danaee, M., Soh, K. L., Soh, K. G., & Japar, S. (2018). Stress and anxiety among mothers of premature infants in a Malaysian neonatal intensive care unit. Journal of Reproductive and Infant Psychology, 37(2), 193-205. https://doi.org/10.1080/02646838.2018.1540861

Rezaei, N., Azadi, A., Zargousi, R., Sadoughi, Z., Tavalaee, Z., & Rezayati, M. (2016). Maternal health-related quality of life and its predicting factors in the postpartum period in Iran. Scientifica, 2016, 8542147. https://doi.org/10.1155/2016/8542147

Sockol, L. E., & Battle, C. L. (2015). Maternal attitudes, depression, and anxiety in pregnant and postpartum multiparous women. Archives of Women's Mental Health, 18(4), 585-593. https://doi.org/10.1007/s00737-015-0511-6

The WHOQOL Group. (1998). The World Health Organization quality of life assessment (WHOQOL): development and general psychometric properties. Social Science & Medicine, 46(12), 1569-1585. https://doi.org/10.1016/S0277-9536(98)00009-4

Trombini, E., Surcinelli, P., Piccioni, A., Alessandroni, R., & Faldella, G. (2008). Environmental factors associated with stress in mothers of preterm newborns. Acta Paediatrica, 97(7), 894-898. https://doi.org/10.1111/j.1651-2227.2008.00849.x

Wada, F. H., Prabandari, Y. S., & Hapsari, E. D. (2020). Bonding and attachment experience among postnatal mothers with spontaneous childbirth. Belitung Nursing Journal, 6(1), 14-20. https://doi.org/10.33546/bnj.779

Wang, P., Liou, S.-R., & Cheng, C.-Y. (2013). Prediction of maternal quality of life on preterm birth and low birthweight: A longitudinal study. BMC Pregnancy and Childbirth, 13(1), 1-11. https://doi.org/10.1186/1471-2393-13-124

Webb, D. A., Bloch, J. R., Coyne, J. C., Chung, E. K., Bennett, I. M., & Culhane, J. F. (2008). Postpartum physical symptoms in new mothers: Their relationship to functional limitations and emotional well‐being. Birth, 35(3), 179-187. https://doi.org/10.1111/j.1523-536X.2008.00238.x

Webster, J., Nicholas, C., Velacott, C., Cridland, N., & Fawcett, L. (2011). Quality of life and depression following childbirth: Impact of social support. Midwifery, 27(5), 745-749. https://doi.org/10.1016/j.midw.2010.05.014

Williams, A., Herron-Marx, S., & Carolyn, H. (2007). The prevalence of enduring postnatal perineal morbidity and its relationship to perineal trauma. Midwifery, 23(4), 392-403. https://doi.org/10.1016/j.midw.2005.12.006

Witt, W. P., Litzelman, K., Spear, H. A., Wisk, L. E., Levin, N., McManus, B. M., & Palta, M. (2012). Health-related quality of life of mothers of very low birth weight children at the age of five: Results from the newborn lung project statewide cohort study. Quality of Life Research, 21(9), 1565-1576. https://doi.org/10.1007/s11136-011-0069-3

Woodward, L. J., Bora, S., Clark, C. A. C., Montgomery-Hönger, A., Pritchard, V. E., Spencer, C., & Austin, N. C. (2014). Very preterm birth: Maternal experiences of the neonatal intensive care environment. Journal of Perinatology, 34(7), 555-561. https://doi.org/10.1038/jp.2014.43

Yaacob, H. (2005). Unity in Malay family. Jurnal Pengajian Melayu, 16, 187-199.

Zubaran, C., & Foresti, K. (2011). The correlation between breastfeeding and maternal quality of life in southern Brazil. Breastfeeding Medicine, 6(1), 25-30. https://doi.org/10.1089/bfm.2010.0017

Zubaran, C., Foresti, K., Schumacher, M. V., Thorell, M. R., Muller, L. C., & Amoretti, A. L. (2009). An assessment of maternal quality of life in the postpartum period in southern Brazil: A comparson of two questionnaires. Clinics, 64, 751-756. https://doi.org/10.1590/S1807-59322009000800007

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