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Meta-Analysis
. 2019 Mar;39(3):375-386.
doi: 10.1038/s41372-018-0310-9. Epub 2019 Jan 18.

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

Animesh Sabnis  1 , Sofia Fojo  2 , Sameera S Nayak  3 , Elizabeth Lopez  4 , Derjung M Tarn  5 , Lonnie Zeltzer  6
Affiliations
Meta-Analysis

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

Animesh Sabnis et al. J Perinatol. 2019 Mar.

Abstract

Objective: 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.

Results: 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.

Conclusion: 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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Conflict of interest statement

CONFLICT OF INTEREST: The authors have no conflicts of interest and no financial relationships relevant to this article to disclose.

Figures

Figure 1.
Figure 1.
Study selection flow diagram.
Figure 2.
Figure 2.
Forest plot of randomized studies. (SMD – standardized mean difference)
Figure 3.
Figure 3.
Funnel plot of randomized studies. Three outlier effect sizes represent two studies by Behestipour et al and Mianaei et al that were excluded in post-hoc sensitivity analysis.
See this image and copyright information in PMC

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