Early Intervention for Preterm Infants and Their Mothers

Abstract

This systematic review evaluates the efficacy of various early interventions on maternal emotional outcomes, mother-infant interaction, and subsequent infant outcomes during neonatal intensive care unit admission and postdischarge. Key interventions associated with outcomes in both the neonatal intensive care unit and postdischarge (ie, home) settings are summarized. A comprehensive search of peer-reviewed randomized controlled trials involving early interventions for infants and their mother published between 1993 and 2013 in the electronic databases PubMed, CINAHL, EMBASE, PsychINFO, and Cochrane was undertaken. Methodological quality was assessed using the PEDro scale to evaluate internal and external validity of the study. Twelve randomized controlled trials were included in the review, and all used some form of parenting education. The interventions had limited effects on maternal stress and mother-infant interaction and positive effects on maternal anxiety, depressive symptoms, and maternal coping. There were positive effects on infants' short-term outcomes for length of stay and breast-feeding rate. Positive and clinically meaningful effects of early interventions were seen in some physiological/psychological outcomes of mothers and preterm infants. It is important for nurses to foster close mother-infant contact and increase maternal competence during and after the infant's hospitalization period.

Effectiveness of early intervention programs for parents of preterm infants: a meta-review of systematic reviews

“… RCTs and observational studies Cochrane Libraries, PubMed, LILACS, African Medicus, EMRO and all World Health Organization Regional Databases 15 McGregor et al, 2012 [ 35 ] Enhancing parent-infant bonding using kangaroo care: a structured review To review the literature on the effectiveness of kangaroo care with premature infants for enhancing bonding. RCTs and observational studies Medline, CINAHL, OTDBASE, PsycINFO, Applied Social Sciences Index and Abstracts (ASSIA), Allied and Complimentary Medicine Database (AMED), and British Nursing Index (BNI) 6 Zhang et al, 2014 [ 24 ] Early Intervention for preterm infants and their mothers To evaluate the efficacy of early interventions on maternal emotions, mother-infant interaction and infant development outcomes RCTs PubMed, CINAHL, EMBASE, PsychINFO, Cochrane library 12 …”

“…Various early intervention programs have been developed and delivered for parents of preterm babies and some systematic reviews (SRs) have synthesised the evidence on the effectiveness of these programmes [ 21 – 24 ]. While individual reviews have been successful in identifying the components and assessing the effectiveness of certain interventions on parental and infant outcomes, they often focus on specific interventions [ 21 ], components [ 25 ], or outcomes [ 26 ], which limit their ability to provide a comprehensive picture of the effectiveness of early intervention programs for the parents of preterm babies.…”

NICU-based Interventions To Reduce Maternal Depressive and Anxiety Symptoms: A Meta-analysis

“…This study adds to previous literature reviewing the effects of interventions on the mental health of NICU parents by providing an updated, rigorous, and more focused critique of these interventions. Unlike several earlier studies with broader inclusion criteria, 13,34,35 we evaluated randomized trials of interventions delivered in the NICU setting in which maternal depressive and anxiety symptoms were assessed as outcomes. The only previous meta-analysis in this area, 13 which reported significant intervention benefits for maternal anxiety and depressive symptoms, required inclusion of a community intervention component, whereas the current meta-analysis evaluated interventions delivered fully or primarily in the NICU setting.…”

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

“…No prior review has comprehensively synthesized studies of interventions to reduce distress in NICU parents at large. Previous systematic reviews selected narrow scopes that limited their applicability across varied patient populations, treatment modalities, and psychological outcomes [20][21][22][23][24]. First, few reviews examined the effect of interventions on fathers' distress symptoms, even though NICU fathers experience birth-related psychological distress [25].…”