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Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes.
Early Hum Dev. 2018 02; 117:32-38.EH

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 5years among preterm infants.

METHODS

Eighty-one preterm infants born ≤32weeks 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 5years 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 4-5years.

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.

Authors+Show Affiliations

Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: pineda_r@kids.wustl.edu.The Belle Center, St. Louis, MO, USA.Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.St. Louis Children's Hospital, St. Louis, MO, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29275070

Citation

Pineda, Roberta, et al. "Parent Participation in the Neonatal Intensive Care Unit: Predictors and Relationships to Neurobehavior and Developmental Outcomes." Early Human Development, vol. 117, 2018, pp. 32-38.
Pineda R, Bender J, Hall B, et al. Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes. Early Hum Dev. 2018;117:32-38.
Pineda, R., Bender, J., Hall, B., Shabosky, L., Annecca, A., & Smith, J. (2018). Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes. Early Human Development, 117, 32-38. https://doi.org/10.1016/j.earlhumdev.2017.12.008
Pineda R, et al. Parent Participation in the Neonatal Intensive Care Unit: Predictors and Relationships to Neurobehavior and Developmental Outcomes. Early Hum Dev. 2018;117:32-38. PubMed PMID: 29275070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes. AU - Pineda,Roberta, AU - Bender,Joy, AU - Hall,Bailey, AU - Shabosky,Lisa, AU - Annecca,Anna, AU - Smith,Joan, Y1 - 2017/12/21/ PY - 2017/10/26/received PY - 2017/12/08/revised PY - 2017/12/10/accepted PY - 2017/12/25/pubmed PY - 2018/10/30/medline PY - 2017/12/25/entrez KW - Attachment KW - Development KW - Environment KW - Holding KW - Neonatal intensive care unit KW - Outcomes KW - Parent engagement KW - Participation KW - Presence KW - Preterm KW - Skin-to-skin care KW - Visitation SP - 32 EP - 38 JF - Early human development JO - Early Hum Dev VL - 117 N2 - 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 5years among preterm infants. METHODS: Eighty-one preterm infants born ≤32weeks 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 5years 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 4-5years. 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. SN - 1872-6232 UR - https://www.unboundmedicine.com/medline/citation/29275070/Parent_participation_in_the_neonatal_intensive_care_unit:_Predictors_and_relationships_to_neurobehavior_and_developmental_outcomes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-3782(17)30558-3 DB - PRIME DP - Unbound Medicine ER -