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A biopsychosocial model of NICU family adjustment and child development

Journal of Perinatology volume 43, pages 510–517 (2023)Cite this article

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Abstract

Background

Although infants in Neonatal Intensive Care Units (NICU) are at risk for developmental impairments and parents are at risk for emotional distress, factors that explain outcomes remain unknown. Here, we developed the first biopsychosocial model to explain family adjustment after NICU discharge.

Methods

Participants included 101 families at The Children’s Hospital of Philadelphia Neonatal Follow-Up Program who had been discharged 1.5–2.5 years prior. We gathered data using validated assessments, standardized assessments, and electronic medical records.

Results

Our structural equation model, informed by the Double ABC-X Model, captured the dynamic relationships among infant, parent, couple, and family factors. Infant medical severity, posttraumatic stress, couple functioning, and family resources (e.g., time, money) were key for family adjustment and child development.

Conclusions

Interventions that target parental posttraumatic stress, couple dynamics, parental perception of time for themselves, and access to financial support could be key for improving NICU family outcomes.

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Fig. 1: Double ABC-X model of family stress and adaptation.
Fig. 2: Biopsychosocial model of NICU family outcomes.

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Article 08 July 2021

Stephane A. De Brito, Adelle E. Forth, … Essi Viding

Data availability

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

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Acknowledgements

We are grateful to Emily Reid O’Connor’s family for their support and funding to make this study possible. We thank Marsha Gerdes, Ph.D., Arthur Nezu, Ph.D., DHL, ABPP, and John Medaglia, PhD., for their valuable input on the development of this research project. We thank Thu Bui, M.S. for her assistance with data collection. We are also grateful to the Children’s Hospital of Philadelphia Neonatal Follow-Up Program at Buerger for supporting study recruitment. We are deeply appreciative to the resilient families who took the time to share their experiences and participate in this study.

Funding

This research was funded by the Emily Reid O’Connor Endowed Fellowship at Drexel University. Victoria Grunberg is currently supported by an NIH T32 fellowship (T32MH112485).

Author information

Authors and Affiliations

  1. Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA

    Victoria A. Grunberg

  2. Division of Newborn Medicine, MassGeneral for Children, Boston, MA, USA

    Victoria A. Grunberg

  3. Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA

    Victoria A. Grunberg & Pamela A. Geller

  4. Division of Neonatology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Casey Hoffman & Chavis A. Patterson

  5. Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Casey Hoffman & Chavis A. Patterson

Authors
  1. Victoria A. Grunberg
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  4. Chavis A. Patterson
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Contributions

VAG conceptualized and designed the study, coordinated, supervised, and conducted data collection and analyses, and led manuscript writing and revising. PAG contributed to the study conceptualization, methodology, funding acquisition, data curation and provided supervision, resources, and reviewed and revised the manuscript. CH contributed to study design, methodology, investigation and provided supervision, resources, and reviewed and revised the manuscript. CAP contributed to study design, methodology and provided supervision, resources, and reviewed and revised the manuscript. All authors approved the final manuscript and agreed to be accountable for all aspects of the work.

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Correspondence to Victoria A. Grunberg.

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Grunberg, V.A., Geller, P.A., Hoffman, C. et al. A biopsychosocial model of NICU family adjustment and child development. J Perinatol 43, 510–517 (2023). https://doi.org/10.1038/s41372-022-01585-1

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