Mothers treated in the same room as preterm newborns have less stress: Study

Active participation in care by parents and zero separation between parents and their newborns is highly recommended during infant hospitalization in the neonatal intensive care unit (NICU).

A study was conducted to study the association of the family-integrated care (FICare) model with maternal mental health at hospital discharge of preterm newborns compared with standard neonatal care (SNC). This prospective, multicenter cohort study included mothers with infants born preterm treated in level-2 neonatal units in the Netherlands (1 unit with single-family rooms [the FICare model] and 2 control sites with standard care in open bay units) between May 2017 and January 2020 as part of the AMICA study (fAMily Integrated Care in the neonatal ward). Participants included mothers of preterm newborns admitted to participating units. Data analysis was performed from January to April 2021.

FICare model in single-family rooms with complete couplet-care for the mother-newborn dyad during maternity and/or neonatal care. Maternal mental health, measured using the Parental Stress Scale: NICU (PSS-NICU). Secondary outcomes included survey scores on the Hospital Anxiety and Depression Scale, Postpartum Bonding Questionnaire, Perceived Maternal Parenting Self-efficacy Scale, and satisfaction with care (using EMPATHIC-N). Parent participation (using the CO-PARTNER tool) was assessed as a potential mediator of the association of the FICare model on outcomes with mediation analyses.

The results of the study are:

• A total of 296 mothers were included; 124 of 141 mothers (87.9%) in the FICare model and 115 of 155 (74.2%) mothers in SNC responded to questionnaires
• Mothers in the FICare model had lower total PSS-NICU stress scores at discharge than mothers in SNC, and specifically had lower scores for mother-newborn separation.
• Mothers in the FICare model were present more and participated more in neonatal care.
• Active parent participation was a significant mediator of the association between the FICare model and less maternal depression and anxiety, higher maternal self-efficacy, and better mother-newborn bonding.

Thus, the FICare model in our study was associated with less maternal stress at discharge; mothers were more present and participated more in the care for their newborns than in SNC, which was associated with improved maternal mental health outcomes. Future intervention strategies should aim at reducing mother-newborn separation and intensifying active parent participation in neonatal care.

Reference:

Association of a Zero-Separation Neonatal Care Model With Stress in Mothers of Preterm Infants by Nicole R. van Veenendaal, et al. published in the JAMA Netw Open

doi:10.1001/jamanetworkopen.2022.4514

Keywords:

Mothers, treatment, same room, preterm, newborns, less, stress, Nicole R. van Veenendaal, Anne A. M. W. van Kempen, Birit F. P. Broekman, Femke de Groof, Henriette van Laerhoven, Maartje E. N. van den Heuvel, Judith J. M. Rijnhart, Johannes B. van Goudoever, Sophie R. D. van der Schoor, Zero-Separation, Association, JAMA Netw Open