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Reducing parental trauma and stress in neonatal intensive care: systematic review and meta-analysis of hospital interventions

Journal of Perinatology volume 39, pages 375–386 (2019)Cite this article

Subjects

Abstract

Objective

To classify NICU interventions for parental distress and quantify their effectiveness.

Study design

We systematically reviewed controlled studies published before 2017 measuring NICU parental distress, defined broad intervention categories, and used random-effects meta-analysis to quantify treatment effectiveness.

Results

Among 1643 unique records, 58 eligible trials predominantly studied mothers of preterm infants. Interventions tested in 22 randomized trials decreased parental distress (p < 0.001) and demonstrated improvement beyond 6 months (p < 0.005). In subgroup analyses, complementary/alternative medicine and family-centered instruction interventions each decreased distress symptoms (p < 0.01), with fathers and mothers improving to similar extents. Most psychotherapy studies decreased distress individually but did not qualify for meta-analysis as a group.

Conclusion

NICU interventions modestly reduced parental distress. We identified family-centered instruction as a target for implementation and complementary/alternative medicine as a target for further study. Investigators must develop psychosocial interventions that serve NICU parents at large, including fathers and parents of full-term infants.

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Acknowledgements

The authors wish to thank Bethany Myers for library guidance, Sitaram Vangala for statistical guidance, Isabell Purdy for intervention-classification input, and Catherine Mogil for critical feedback. Database services provided by the NIH/NCATS grant UL1TR000124.

Funding

This study was supported by a UCLA Mattel Children’s Discovery and Innovation Institute Seed Grant. This study was supported exclusively by intramural funding.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology & Developmental Biology, University of California—Los Angeles (UCLA), Los Angeles, CA, USA

    Animesh Sabnis & Elizabeth Lopez

  2. Keck School of Medicine of University of Southern California, Los Angeles, CA, USA

    Sofia Fojo

  3. Institute for Health Equity and Social Justice Research, Northeastern University, Boston, MA, USA

    Sameera S. Nayak

  4. Department of Family Medicine, University of California—Los Angeles (UCLA), Los Angeles, CA, USA

    Derjung M. Tarn

  5. Departments of Pediatrics, Anesthesiology, Psychiatry and Biobehavioral Sciences, University of California—Los Angeles (UCLA), Los Angeles, CA, USA

    Lonnie Zeltzer

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  1. Animesh Sabnis
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  4. Elizabeth Lopez
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Contributions

AS conceptualized, designed, and supervised the study, led the data collection and qualitative synthesis, carried out the quantitative synthesis and final analyses, drafted and revised the final manuscript, and approved the final manuscript as submitted. SF collected data, carried out initial analyses, revised the final manuscript, and approved the final manuscript as submitted. SSN collected data, carried out initial analyses, revised the final manuscript, and approved the final manuscript as submitted. EL collected data, carried out initial analyses, revised the final manuscript, and approved the final manuscript as submitted. DMT conceptualized the study, oversaw the quantitative analysis, revised the final manuscript, and approved the final manuscript as submitted. LZ conceptualized the study, oversaw the qualitative analysis, revised the final manuscript, and approved the final manuscript as submitted.

Corresponding author

Correspondence to Animesh Sabnis.

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The authors declare that they have no conflict of interest.

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Sabnis, A., Fojo, S., Nayak, S.S. et al. Reducing parental trauma and stress in neonatal intensive care: systematic review and meta-analysis of hospital interventions. J Perinatol 39, 375–386 (2019). https://doi.org/10.1038/s41372-018-0310-9

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  • DOI: https://doi.org/10.1038/s41372-018-0310-9

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