Adella Jacklyn, Maraschin Francesca Giulia, Nagraj Shobhana
Nuffield Department of Medicine, Health Systems Collaborative, Centre for Global Health Research, University of Oxford, Oxford, United Kingdom.
Department of Public Health and Primary Care, Primary Care Unit, University of Cambridge, Cambridge, United Kingdom.
PLOS Glob Public Health. 2025 Jul 3;5(7):e0004900. doi: 10.1371/journal.pgph.0004900. eCollection 2025.
Preterm birth is the leading cause of under-five mortality. Family-centred care (FCC) interventions may improve outcomes related to prematurity and may be used to address this issue to achieve the Sustainable Development Goals. We aimed to consolidate the scope of evidence and components of FCC interventions for preterm infants globally and see its relevance for low-resource settings. We conducted an umbrella review informed by the Joanna Briggs Institute (JBI) guidelines. Systematic literature reviews evaluating FCC in the preterm or high-risk infant population and their families were identified from six databases. Keywords included "family-centred care", "premature infants", "neonatal intensive care unit", and their relevant synonyms. Quality appraisal was conducted using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses and data extraction performed to an agreed table. Thematic analysis was carried out to categorise the components of FCC interventions. Forty-four reviews were included in the umbrella review. Outcomes were observed on the parents in 40 studies, the infant in 19, the health care provider in 13, and the health system in 7. Most studies focused on inpatient settings (79.6%) and were conducted primarily in high-income countries (92.3%). The components identified were general FCC, health system design, parent support, partnership in care, and information and communication. Overall, FCC interventions have a positive impact on parental, infant, and health system outcomes, with consistent reporting of FCC impact on parental well-being and satisfaction, infant length of stay, feeding and growth, and hospital readmission rates. FCC interventions have the potential to improve preterm infant health system outcomes. To maximise impact, FCC interventions need to be further explored in low-resource and post-discharge settings, where the burden of premature infant morbidity and mortality is highest. Evidence in both these settings is scarce. Future research efforts should aim to close these evidence gaps.
早产是五岁以下儿童死亡的主要原因。以家庭为中心的护理（FCC）干预措施可能会改善与早产相关的结局，并可用于解决这一问题以实现可持续发展目标。我们旨在汇总全球范围内针对早产儿的FCC干预措施的证据范围和组成部分，并探讨其在资源匮乏地区的相关性。我们根据乔安娜·布里格斯研究所（JBI）的指南进行了一项汇总分析。从六个数据库中识别出评估早产儿或高危婴儿群体及其家庭的FCC的系统文献综述。关键词包括“以家庭为中心的护理”、“早产儿”、“新生儿重症监护病房”及其相关同义词。使用JBI系统评价和研究综合批判性评价清单进行质量评估，并按照商定的表格进行数据提取。进行主题分析以对FCC干预措施的组成部分进行分类。汇总分析纳入了44篇综述。在40项研究中观察了对父母的结局，19项研究中观察了对婴儿的结局，13项研究中观察了对医疗服务提供者的结局，7项研究中观察了对卫生系统的结局。大多数研究聚焦于住院环境（79.6%），并且主要在高收入国家开展（92.3%）。确定的组成部分包括一般FCC、卫生系统设计、家长支持、护理中的伙伴关系以及信息与沟通。总体而言，FCC干预措施对父母、婴儿和卫生系统结局具有积极影响，一致报告了FCC对父母幸福感和满意度、婴儿住院时间、喂养和生长以及医院再入院率的影响。FCC干预措施有改善早产儿卫生系统结局的潜力。为了使影响最大化，需要在资源匮乏地区和出院后环境中进一步探索FCC干预措施，因为这些环境中早产儿发病和死亡的负担最高。这两种环境中的证据都很稀少。未来的研究工作应旨在填补这些证据空白。
