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



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.


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.

Author information




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.

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Correspondence to Animesh Sabnis.

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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).

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