To classify NICU interventions for parental distress and quantify their effectiveness.
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.
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.
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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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.
This study was supported by a UCLA Mattel Children’s Discovery and Innovation Institute Seed Grant. This study was supported exclusively by intramural funding.
Conflict of interest
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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