Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;40(Suppl 1):36-46.
doi: 10.1038/s41372-020-0753-7.

Impact of restrictions on parental presence in neonatal intensive care units related to coronavirus disease 2019

Ashley Darcy Mahoney  1   2   3 , Robert D White  4 , Annalyn Velasquez  1   2 , Tyson S Barrett  5 , Reese H Clark  2 , Kaashif A Ahmad  6   7   8
Affiliations

Impact of restrictions on parental presence in neonatal intensive care units related to coronavirus disease 2019

Ashley Darcy Mahoney et al. J Perinatol. 2020 Sep.

Abstract

Objectives: To determine the relationship between the emergence of COVID-19 and neonatal intensive care unit (NICU) family presence as well as how NICU design affects these changes.

Study design: A cross-sectional survey from April 21 to 30, 2020. We queried sites regarding NICU demographics, NICU restrictions on parental presence, and changes in ancillary staff availability.

Results: Globally, 277 facilities responded to the survey. NICU policies preserving 24/7 parental presence decreased (83-53%, p < 0.001) and of preserving full parental participation in rounds fell (71-32%, p < 0.001). Single-family room design NICUs best preserved 24/7 parental presence after the emergence of COVID-19 (single-family room 65%, hybrid-design 57%, open bay design 45%, p = 0.018). In all, 120 (43%) NICUs reported reductions in therapy services, lactation medicine, and/or social work support.

Conclusions: Hospital restrictions have significantly limited parental presence for NICU admitted infants, although single-family room design may attenuate this effect.

PubMed Disclaimer

Conflict of interest statement

The Methodist Healthcare System IRB approved this research. RDW has received consulting fees from Philips HealthTech, owns equity in Mednax, and received lecture fees from P + G (Pampers). RDW also holds patents for two products (not for sale). The remaining authors have declared no competing interests.

Figures

Fig. 1
Fig. 1. Geographical distribution of responding NICUs, entry policy changes, and level of parental participation in rounds.
Responses were received from NICUs in 40 out of 50 US States, with 3 states having more than 15 NICUs respond to the survey (a). The average date of changing hospital entry policies varied by state, with the majority averaging policy change between March 16 and 31 (b). Prior to the onset of the COVID-19 pandemic, permitting full parental participation in NICU rounds was commonplace (c). However, during the pandemic very few states had a majority of NICUs allowing full parental participation in rounds.
Fig. 2
Fig. 2. The cumulative count of changes in hospital entry policies by calendar date.
Very few hospitals altered their entry dates in January or February, 2020. However this rapidly changed in March with most NICUs changing their policy prior to the issuance of specific guidance from the Centers for Disease Control and Prevention (CDC) on March 20, 2020.
Fig. 3
Fig. 3. Flow diagram of restrictions to parental presence in the NICU after the emergence of COVID-19.
Overall, 130 of 277 NICUs (47%) had restrictions to NICU parental in the NICU during the Covid-19 pandemic. Of these, most allowed only a single parent at the bedside and 33 NICUs required families to choose a single parent for the entire hospital stay. Prohibition of parental presence in the NICU was rare but occurred at 7 sites (3%).
See this image and copyright information in PMC

References

    1. United States Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Division of Vital Statistics, Natality public-use data 2016-2018, on CDC WONDER Online Database, September 2019. http://wonder.cdc.gov/natality-expanded-current.html
    1. Baley J. Committee on fetus and newborn. Skin-to-skin care for term and preterm infants in the neonatal ICU. Pediatrics. 2015;136:596–9. doi: 10.1542/peds.2015-2335. - DOI - PubMed
    1. Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2016 doi: 10.1002/14651858.cd002771.pub4. - DOI - PMC - PubMed
    1. Welch M, Firestein M, Austin J, Hane A, Stark R, Hofer M, et al. Family Nurture Intervention in the Neonatal Intensive Care Unit improves social‐relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial. J Child Psychol Psychiatry. 2015;56:1202–11. doi: 10.1111/jcpp.12405. - DOI - PubMed
    1. Lee L, Carter M, Stevenson S, Harrison H. Improving family-centered care practices in the NICU. Neonatal N. 2014;33:125–32. doi: 10.1891/0730-0832.33.3.125. - DOI - PubMed