Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes. (February 2018)

• Record Type: Journal Article
• Authors: Pineda, Roberta; Bender, Joy; Hall, Bailey; Shabosky, Lisa; Annecca, Anna; Smith, Joan
• Is Part Of: Early human development. Volume 117(2018)
• Page Start: 32
• Page End: 38
• Publication Date: 2018-02
• Subjects: Neonatal intensive care unit -- Preterm -- Parent engagement -- Participation -- Development -- Holding -- Skin-to-skin care -- Presence -- Visitation -- Outcomes -- Environment -- Attachment; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2017.12.008
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Objective: To 1) define predictors of parent presence, any holding, holding in arms, and skin-to-skin care in the NICU and 2) investigate the relationships between parent participation and a) early neurobehavior and b) developmental outcomes at age 4 to 5 years among preterm infants. Methods: Eighty-one preterm infants born ≤ 32 weeks estimated gestational age were prospectively enrolled within one week of life in a level III–IV NICU. Parent (maternal and paternal) presence and holding (including holding in arms and skin-to-skin care) were tracked throughout NICU hospitalization. Neurobehavior at term equivalent age and development at 4 to 5 years were determined using standardized assessments. Results: The median number of days per week parents were documented to be present over NICU hospitalization was 4.0 (IQR = 2.4–5.8) days; days held per week 2.8 (IQR = 1.4–4.3) days [holding in arms days per week was 2.2 (IQR = 1.2–3.2) days and parent skin-to-skin care days per week was 0.2 (IQR = 0.0–0.7) days]. More parent presence was observed among mothers who were Caucasian, married, older, or employed and among those who had fewer children, familial support and provided breast milk (p < 0.05). More holding was observed in infants with fewer medical interventions (p < 0.05) and among those who were Caucasian, had a father who was employed, had fewer children and family support (p < 0.05). More parent holding in the NICU was related to better reflex development at term age (p = 0.02). More parent skin-to-skin care was related to better infant reflexes (p = 0.03) and less asymmetry (p = 0.04) at term and better gross motor development (p = 0.02) at 4–5 years. Discussion: Social and medical factors appear to impact parent presence, holding, and skin-to-skin care in the NICU. Parent holding is related to better developmental outcomes, which highlights the importance of engaging families in the NICU. Highlights: In the NICU, parents were present an average of 4 days/week and held their infants 2 days/week. More parent holding in the NICU was related to better neurobehavior prior to NICU discharge. More skin-to-skin care in the NICU was related to better gross and fine motor skills at 4–5 years.