Publication
Family Involvement in the Routine Care of Hospitalized Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis
Publisher:
American Academy of Pediatrics (AAP)
Date:
08-2022
DOI:
10.1542/PEDS.2022-057092O
Abstract: Preterm and low birth weight (LBW) infants are often separated from parents during hospitalization. Our objective was to assess effects of interventions to increase family involvement in the routine newborn care of preterm or LBW infants compared with standard NICU care on infant and parental outcomes. Data sources include Medline, Embase, CINAHL, and World Health Organization Global Index Medicus to August 2021. The study selection included randomized controlled trials (RCTs) of family involvement intervention packages. Data were extracted and pooled with random-effects models. We included 15 RCTs with 5240 participants. All interventions included direct parental bedside care packages varied with respect to additional components. Family involvement interventions decreased retinopathy of prematurity (odds ratio 0.52, 95% confidence interval [CI]: 0.34, 0.80 8 RCTs), length of hospital stay (mean difference [MD] −2.91 days 95% CI: −5.15,−0.82 11 RCTs), and parental stress and anxiety (Parental Stress Scale: MD −0.29 points, 95% CI: −0.56,−0.01, 2 RCTs Anxiety State-Trait scale: MD −1.79, 95% CI: −3.11,−0.48 2 RCTs). Family involvement increased weight gain velocity (MD 2.09 g/day 95% CI: 1.27, 2.91 3 RCTs), neurobehavioral exam scores (MD: 1.11 95% CI: 0.21, 2.01 2 RCTs) and predominant or exclusive breastmilk intake (odds ratio 1.34 95% CI: 1.01, 1.65 3 RCTs). It may decrease rates of bronchopulmonary dysplasia, infection, and intraventricular hemorrhage. There were no effects on mortality or necrotizing enterocolitis. Certainty of evidence ranged from low to moderate. Family involvement has a beneficial role on several infant and parental outcomes.