Sachs Children's Hospital, Södersjukhuset, SE-118 83 Stockholm, Sweden.
Pediatrics. 2010 Feb;125(2):e278-85. doi: 10.1542/peds.2009-1511. Epub 2010 Jan 25.
Parental involvement in the care of preterm infants in NICUs is becoming increasingly common, but little is known about its effect on infants' length of hospital stay and infant morbidity. Our goal was to evaluate the effect of a new model of family care (FC) in a level 2 NICU, where parents could stay 24 hours/day from admission to discharge.
A randomized, controlled trial was conducted in 2 NICUs (both level 2), including a standard care (SC) ward and an FC ward, where parents could stay from infant admission to discharge. In total, 366 infants born before 37$$\raisebox{1ex}{$0$}!\left/ !\raisebox{-1ex}{$7$}\right.$$ weeks of gestation were randomly assigned to FC or SC on admission. The primary outcome was total length of hospital stay, and the secondary outcome was short-term infant morbidity. The analyses were adjusted for maternal ethnic background, gestational age, and hospital site.
Total length of hospital stay was reduced by 5.3 days: from a mean of 32.8 days (95% confidence interval [CI]: 29.6-35.9) in SC to 27.4 days (95% CI: 23.2-31.7) in FC (P = .05). This difference was mainly related to the period of intensive care. No statistical differences were observed in infant morbidity, except for a reduced risk of moderate-to-severe bronchopulmonary dysplasia: 1.6% in the FC group compared with 6.0% in the SC group (adjusted odds ratio: 0.18 [95% CI: 0.04-0.8]).
Providing facilities for parents to stay in the neonatal unit from admission to discharge may reduce the total length of stay for infants born prematurely. The reduced risk of moderate-to-severe bronchopulmonary dysplasia needs additional investigation.
在新生儿重症监护病房（NICU）中，父母参与早产儿护理的现象越来越普遍，但人们对其对婴儿住院时间和婴儿发病率的影响知之甚少。我们的目标是评估一种新的家庭护理（FC）模式在 2 级 NICU 中的效果，在这种模式中，父母可以从入院到出院 24 小时/天陪伴。
在 2 家 NICU（均为 2 级）中进行了一项随机对照试验，包括一个标准护理（SC）病房和一个 FC 病房，父母可以从婴儿入院到出院一直陪伴。共有 366 名胎龄<37$$\raisebox{1ex}{$0$}!\left/ !\raisebox{-1ex}{$7$}\right.$$ 周的早产儿在入院时被随机分配到 FC 或 SC。主要结局是总住院时间，次要结局是短期婴儿发病率。分析调整了母亲的种族背景、胎龄和医院地点。
总住院时间缩短了 5.3 天：从 SC 的平均 32.8 天（95%置信区间 [CI]：29.6-35.9）减少到 FC 的 27.4 天（95% CI：23.2-31.7）（P =.05）。这种差异主要与重症监护期有关。除了中度至重度支气管肺发育不良的风险降低外，婴儿发病率没有统计学差异：FC 组为 1.6%，而 SC 组为 6.0%（调整后的优势比：0.18 [95% CI：0.04-0.8]）。
为父母提供从入院到出院在新生儿病房陪伴的设施可能会缩短早产儿的总住院时间。中度至重度支气管肺发育不良风险降低需要进一步调查。
