Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA.
Matern Child Health J. 2020 May;24(5):587-600. doi: 10.1007/s10995-020-02905-7.
To assess the impact of financial support on maternal caregiving activities for preterm infants.
We conducted a small randomized controlled trial (RCT) in two Massachusetts Neonatal Intensive Care Units (NICUs). We enrolled 46 Medicaid-eligible mothers of preterm infants between January 2017 and June 2018 and randomly assigned them to a treatment group (up to 3 weekly financial transfers of $200 each while their infant was in the hospital) or a control group. We collected hospital-record data while the infant was admitted. The primary outcome was a binary variable indicating skin-to-skin care (STSC) was provided during a hospital day. Secondary outcomes included daily maternal visitation, daily provision of breastmilk, neonatal growth and length of stay (LOS). Multilevel generalized linear models with random effects were used to estimate treatment effects on daily maternal behaviors and ordinary least squares models were used to estimate impacts on neonatal growth and LOS.
We assigned 25 women to the intervention and 21 to the control and observed them over 703 days of their infants' hospitalization. Mothers who received financial support were more likely to provide STSC (adjusted risk ratio: 1.85; 95% confidence interval [CI] 1.31-2.62) and breastmilk (adjusted risk ratio: 1.36; 95% CI 1.06-1.75) while their infant was in the NICU. We see no statistically significant impact on neonatal growth outcomes or LOS, though estimated confidence intervals are imprecise.
Our evidence demonstrates the potential for financial support to increase mothers' engagement with caregiving behaviors for preterm infants during the NICU stay.
评估经济支持对早产儿产妇照护活动的影响。
我们在马萨诸塞州的两个新生儿重症监护病房（NICU）进行了一项小型随机对照试验（RCT）。我们招募了 2017 年 1 月至 2018 年 6 月期间符合医疗补助条件的 46 名早产儿母亲，并将其随机分配到治疗组（在婴儿住院期间，最多每周进行 3 次 200 美元的经济转账）或对照组。我们在婴儿住院期间收集了医院记录数据。主要结局是一个二元变量，表明在医院日提供了皮肤接触护理（STSC）。次要结局包括每天产妇探视、每天提供母乳、新生儿生长和住院时间（LOS）。使用具有随机效应的多级广义线性模型估计治疗对每日产妇行为的影响，使用普通最小二乘法模型估计对新生儿生长和 LOS 的影响。
我们将 25 名女性分配到干预组，21 名女性分配到对照组，并观察了她们婴儿住院的 703 天。接受经济支持的母亲更有可能提供 STSC（调整后的风险比：1.85；95%置信区间[CI]1.31-2.62）和母乳（调整后的风险比：1.36；95%CI 1.06-1.75），而他们的婴儿在 NICU 中。我们没有看到对新生儿生长结果或 LOS 有统计学意义的影响，尽管估计的置信区间不太精确。
我们的证据表明，经济支持有可能增加母亲在 NICU 期间对早产儿产妇照护行为的参与度。
