Family Rooms in Neonatal Intensive Care Units and Neonatal Outcomes: An International Survey and Linked Cohort Study

Abstract

Objectives: To evaluate the proportion of neonatal intensive care units with facilities supporting parental presence in their infants' rooms throughout the 24-hour day (i.e., infant-parent rooms) in highincome countries and to analyze the association of this with outcomes of extremely preterm infants. Study design: In this survey and linked cohort study, we analyzed unit design and facilities for parents in 10 neonatal networks of 11 countries. We compared the composite outcome of mortality or major morbidity, length of stay, and individual morbidities between neonates admitted to units with and without infantparent rooms by linking survey responses to patient data from the year 2015 for neonates of <29 weeks' gestation. Results: Of 331 units, 13.3% (44/331) provided infant-parent rooms. Patient-level data were available for 4662 infants admitted to 159 units in 7 networks; 28% of the infants were cared for in units with infant-parent rooms. Neonates from units with infant-parent rooms had lower odds of mortality or major morbidity (adjusted OR 0.76; 95% CI 0.64, 0.89), including lower odds of sepsis and bronchopulmonary dysplasia, than those from units without infant-parent rooms. The adjusted mean length of stay was 3.4 days shorter (95% CI -4.7, -3.1) in the units with infant-parent rooms. Conclusions: The majority of units in high-income countries lack facilities to support parents' presence in their infants' rooms 24 hours per day. The availability vs absence of infant-parent rooms was associated with lower odds of composite outcome of mortality or major morbidity and shorter length of stay.

Parent–infant skin-to-skin contact reduces the electrical activity of the diaphragm and stabilizes respiratory function in preterm infants

“…A recent study reported that singlefamily room care lowered the risk for BPD (adjusted odds ratio 0.72, 95% confidence interval 0.61-0.86). 34 Our results can be a potential explanation for the mechanism behind this association, because single-family room care is related to more frequent and longer SSC. 35 Our study has limitations.…”

Effectiveness of the Close Collaboration with Parents intervention on parent-infant closeness in NICU

“…It is shown that parents’ involvement in infants’ care in hospital enhance long-term cognitive and neurobehavioral development of preterm infants [ 9 – 14 ]. Moreover, increased parental presence and availability of family rooms shorten infants’ hospital stays [ 15 , 16 ]. Skin-to-Skin Contact (SSC) is an effective way to increase closeness.…”

Preterm birth: Educational and mental health outcomes

“…This alleviates parental anxiety and distress at separation, and allows parents to play more of a role in their infant's care, potentially including extended periods of 'Kangaroo care. Unfortunately, most neonatal units in high-income countries currently lack facilities to support parents' presence 24 hours per day (Lehtonen et al, 2020).…”

“…Facilitating parental presence in the NICU may therefore promote better long-term outcomes for preterm babies. Rates of infant mortality, serious medical complications and poorer cognitive functioning are lower in infants cared for in NICUs with access to single family rooms, in which parents can stay with their child 24 hours per day (Lehtonen et al, 2020;Vohr et al, 2017). This alleviates parental anxiety and distress at separation, and allows parents to play more of a role in their infant's care, potentially including extended periods of 'Kangaroo care.…”