Global Advancement of Infants and Mothers (AIM), Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Mater Research Institute, The University of Queensland, NHMRC Centre of Research Excellence in Stillbirth (Stillbirth CRE), South Brisbane, Australia.
Pediatrics. 2022 Aug 1;150(Suppl 1). doi: 10.1542/peds.2022-057092O.
Preterm and low birth weight (LBW) infants are often separated from parents during hospitalization. Our objective was to assess effects of interventions to increase family involvement in the routine newborn care of preterm or LBW infants compared with standard NICU care on infant and parental outcomes.
Data sources include Medline, Embase, CINAHL, and World Health Organization Global Index Medicus to August 2021. The study selection included randomized controlled trials (RCTs) of family involvement intervention packages. Data were extracted and pooled with random-effects models.
We included 15 RCTs with 5240 participants. All interventions included direct parental bedside care; packages varied with respect to additional components. Family involvement interventions decreased retinopathy of prematurity (odds ratio 0.52, 95% confidence interval [CI]: 0.34, 0.80; 8 RCTs), length of hospital stay (mean difference [MD] -2.91 days; 95% CI: -5.15,-0.82; 11 RCTs), and parental stress and anxiety (Parental Stress Scale: MD -0.29 points, 95% CI: -0.56,-0.01, 2 RCTs; Anxiety State-Trait scale: MD -1.79, 95% CI: -3.11,-0.48; 2 RCTs). Family involvement increased weight gain velocity (MD 2.09 g/day; 95% CI: 1.27, 2.91; 3 RCTs), neurobehavioral exam scores (MD: 1.11; 95% CI: 0.21, 2.01; 2 RCTs) and predominant or exclusive breastmilk intake (odds ratio 1.34; 95% CI: 1.01, 1.65; 3 RCTs). It may decrease rates of bronchopulmonary dysplasia, infection, and intraventricular hemorrhage. There were no effects on mortality or necrotizing enterocolitis. Certainty of evidence ranged from low to moderate.
Family involvement has a beneficial role on several infant and parental outcomes.
早产儿和低出生体重儿（LBW）在住院期间通常与父母分离。我们的目的是评估与标准新生儿重症监护病房（NICU）护理相比，增加家庭参与早产儿或 LBW 常规新生儿护理的干预措施对婴儿和父母结局的影响。
数据来源包括 Medline、Embase、CINAHL 和世界卫生组织全球医学索引，截至 2021 年 8 月。研究选择包括家庭参与干预措施包的随机对照试验（RCT）。使用随机效应模型提取和汇总数据。
我们纳入了 15 项 RCT，涉及 5240 名参与者。所有干预措施均包括直接父母床边护理；方案在附加组件方面有所不同。家庭参与干预措施降低了早产儿视网膜病变（比值比 0.52，95%置信区间 [CI]：0.34，0.80；8 项 RCT）、住院时间（平均差异 [MD] -2.91 天；95%CI：-5.15，-0.82；11 项 RCT）和父母压力和焦虑（父母压力量表：MD -0.29 分，95%CI：-0.56，-0.01，2 项 RCT；焦虑状态特质量表：MD -1.79，95%CI：-3.11，-0.48；2 项 RCT）。家庭参与增加了体重增加速度（MD 2.09 g/天；95%CI：1.27，2.91；3 项 RCT）、神经行为检查评分（MD：1.11；95%CI：0.21，2.01；2 项 RCT）和主要或纯母乳喂养（比值比 1.34；95%CI：1.01，1.65；3 项 RCT）。它可能降低支气管肺发育不良、感染和颅内出血的发生率。对死亡率或坏死性小肠结肠炎没有影响。证据的确定性从低到中等不等。
家庭参与对婴儿和父母的几个结局有有益的作用。
