Laccetta Gianluigi, Di Chiara Maria, De Nardo Maria Chiara, Terrin Gianluca
Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Front Psychiatry. 2023 Mar 8;14:998995. doi: 10.3389/fpsyt.2023.998995. eCollection 2023.
Preterm birth and subsequent NICU admission can be a traumatic experience for parents who may subsequently develop post-traumatic stress (PTS) disorder (PTSD). Given that developmental issues are common among children of parents with PTSD, interventions for prevention and treatment are essential.
To assess the most effective non-pharmacological interventions to prevent and/or treat PTS symptoms in parents of preterm newborns.
Systematic review performed in accordance with the PRISMA statements. Eligible articles in English language were searched in MEDLINE, Scopus, and ISI Web of Science databases using the following medical subject headings and terms: "stress disorder, post-traumatic," "parents," "mothers," "fathers," "infant, newborn," "intensive care units, neonatal," and "premature birth." The terms "preterm birth" and "preterm delivery" were also used. Unpublished data were searched in ClinicalTrials.gov website. All intervention studies published until September 9th, 2022 and including parents of newborns with gestational age at birth (GA) <37 weeks which underwent ≥1 non-pharmaceutical interventions for prevention and/or treatment of PTS symptoms related to preterm birth were included. Subgroup analyses were conducted by type of intervention. The quality assessment was performed according to the criteria from the RoB-2 and the "NIH Quality Assessment Tool for Before-After studies."
Sixteen thousand six hundred twenty-eight records were identified; finally, 15 articles (1,009 mothers, 44 fathers of infants with GA ≤ 36 weeks) were included for review. A good standard of NICU care (effective as sole intervention: 2/3 studies) and education about PTSD (effective in association with other interventions: 7/8 studies) could be offered to all parents of preterm newborns. The 6-session Treatment Manual is a complex intervention which revealed itself to be effective in one study with low risk of bias. However, the effectiveness of interventions still remains to be definitively established. Interventions could start within 4 weeks after birth and last 2-4 weeks.
There is a wide range of interventions targeting PTS symptoms after preterm birth. However, further studies of good quality are needed to better define the effectiveness of each intervention.
早产及随后入住新生儿重症监护病房（NICU）对父母来说可能是一段创伤性经历，他们随后可能会患上创伤后应激障碍（PTSD）。鉴于患有创伤后应激障碍的父母的孩子中发育问题很常见，预防和治疗干预措施至关重要。
评估预防和/或治疗早产新生儿父母创伤后应激障碍症状的最有效非药物干预措施。
按照PRISMA声明进行系统评价。在MEDLINE、Scopus和ISI科学网数据库中使用以下医学主题词和术语检索符合条件的英文文章：“应激障碍，创伤后”、“父母”、“母亲”、“父亲”、“婴儿，新生儿”、“重症监护病房，新生儿”和“早产”。还使用了“早产”和“早产分娩”等术语。在ClinicalTrials.gov网站上检索未发表的数据。纳入所有截至2022年9月9日发表的干预研究，这些研究包括出生胎龄（GA）<37周的新生儿的父母，他们接受了≥1种预防和/或治疗与早产相关的创伤后应激障碍症状的非药物干预措施。按干预类型进行亚组分析。根据RoB-2和“美国国立卫生研究院前后研究质量评估工具”的标准进行质量评估。
共识别出16628条记录；最终，纳入15篇文章（1009名母亲，44名GA≤36周婴儿的父亲）进行综述。可以为所有早产新生儿的父母提供良好的新生儿重症监护病房护理标准（作为唯一干预措施有效：2/3的研究）和关于创伤后应激障碍的教育（与其他干预措施联合有效：7/8的研究）。6节治疗手册是一种复杂的干预措施，在一项偏倚风险较低的研究中显示有效。然而，干预措施的有效性仍有待最终确定。干预可在出生后4周内开始，持续2-4周。
有多种针对早产后创伤后应激障碍症状的干预措施。然而，需要进一步的高质量研究来更好地确定每种干预措施的有效性。
