An Integrative Review: Maternal Engagement in the Neonatal Intensive Care Unit and Health Outcomes for U.S.-born Preterm Infants and Their Parents

Overview

Journal AIMS Public Health

Specialty Public Health

Date 2019 Jul 13

PMID 31297402

Citations 18

Authors

Susanne Klawetter

Jennifer C Greenfield

Stephanie Rachel Speer

Kyria Brown

Sunah S Hwang

Affiliations

Soon will be listed here.

Abstract

Hospitals and perinatal organizations recognize the importance of family engagement in the neonatal intensive care unit (NICU). The Agency for Healthcare Research and Quality (AHRQ) defines family engagement as "A set of behaviors by patients, family members, and health professionals and a set of organizational policies and procedures that foster both the inclusion of patients and family members as active members of the health care team and collaborative partnerships with providers and provider organizations." In-unit barriers and facilitators to enhance family engagement are well studied; however, less is known specifically about maternal engagement's influence in the NICU on the health of infants and mothers, particularly within U.S. social and healthcare contexts. In this integrative review, we examine the relationship between maternal engagement in the NICU and preterm infant and maternal health outcomes within the U.S. Results from the 33 articles that met inclusion criteria indicate that maternal engagement in the NICU is associated with infant outcomes, maternal health-behavior outcomes, maternal mental health outcomes, maternal-child bonding outcomes, and breastfeeding outcomes. Skin-to-skin holding is the most studied maternal engagement activity in the U.S. preterm NICU population. Further research is needed to understand what types of engagement are most salient, how they should be measured, and which immediate outcomes are the best predictors of long-term health and well-being.

Citing Articles

'It is an emotional rollercoaster!!!' Experiences of mothers of preterm newborns seeking care at a tertiary hospital in Ghana: a qualitative phenomenological study.

Nukpezah R, Atanuriba G BMJ Open. 2025; 15(1):e093173.

PMID: 39819941 PMC: 11751851. DOI: 10.1136/bmjopen-2024-093173.

Psychological distress in the neonatal intensive care unit: a meta-review.

van Wyk L, Majiza A, Ely C, Singer L Pediatr Res. 2024; 96(6):1510-1518.

PMID: 39327462 PMC: 11624136. DOI: 10.1038/s41390-024-03599-1.

Inpatient Skin-to-skin Care Predicts 12-Month Neurodevelopmental Outcomes in Very Preterm Infants.

Lazarus M, Marchman V, Brignoni-Perez E, Dubner S, Feldman H, Scala M J Pediatr. 2024; 274:114190.

PMID: 39004169 PMC: 11514444. DOI: 10.1016/j.jpeds.2024.114190.

Parents' and neonatal healthcare professionals' views on barriers and facilitators to parental presence in the neonatal unit: a qualitative study.

Schmid S, Arnold C, Jaisli S, Bubl B, Harju E, Kidszun A BMC Pediatr. 2024; 24(1):268.

PMID: 38658901 PMC: 11040849. DOI: 10.1186/s12887-024-04758-3.

The Protective Role of Maternal-Fetal Bonding for Postpartum Bonding Following a NICU Admission.

Ciciolla L, Shreffler K, Quigley A, Price J, Gold K Matern Child Health J. 2024; 28(1):11-18.

PMID: 38165585 PMC: 11195440. DOI: 10.1007/s10995-023-03873-4.

References

Neu M, Browne J, Vojir C . The impact of two transfer techniques used during skin-to-skin care on the physiologic and behavioral responses of preterm infants. Nurs Res. 2000; 49(4):215-23. DOI: 10.1097/00006199-200007000-00005. View

Whipple J . The effect of parent training in music and multimodal stimulation on parent-neonate interactions in the neonatal intensive care unit. J Music Ther. 2001; 37(4):250-68. DOI: 10.1093/jmt/37.4.250. View

Ludington-Hoe S, Anderson G, Swinth J, Thompson C, Hadeed A . Randomized controlled trial of kangaroo care: cardiorespiratory and thermal effects on healthy preterm infants. Neonatal Netw. 2004; 23(3):39-48. DOI: 10.1891/0730-0832.23.3.39. View

Roller C . Getting to know you: mothers' experiences of kangaroo care. J Obstet Gynecol Neonatal Nurs. 2005; 34(2):210-7. DOI: 10.1177/0884217504273675. View

McCain G, Ludington-Hoe S, Swinth J, Hadeed A . Heart rate variability responses of a preterm infant to kangaroo care. J Obstet Gynecol Neonatal Nurs. 2005; 34(6):689-94. PMC: 2133345. DOI: 10.1177/0884217505281857. View

Dunn M, Reilly M, Johnston A, Hoopes Jr R, Abraham M . Development and dissemination of potentially better practices for the provision of family-centered care in neonatology: the family-centered care map. Pediatrics. 2006; 118 Suppl 2:S95-107. DOI: 10.1542/peds.2006-0913F. View

Lau C, Hurst N, Smith E, Schanler R . Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants. J Perinatol. 2007; 27(7):399-408. PMC: 2282065. DOI: 10.1038/sj.jp.7211770. View

Salihu H, Wilson R . Epidemiology of prenatal smoking and perinatal outcomes. Early Hum Dev. 2007; 83(11):713-20. DOI: 10.1016/j.earlhumdev.2007.08.002. View

Johnson A . The maternal experience of kangaroo holding. J Obstet Gynecol Neonatal Nurs. 2007; 36(6):568-73. DOI: 10.1111/j.1552-6909.2007.00187.x. View

10.

Herrmann M, King K, Weitzman M . Prenatal tobacco smoke and postnatal secondhand smoke exposure and child neurodevelopment. Curr Opin Pediatr. 2008; 20(2):184-90. DOI: 10.1097/MOP.0b013e3282f56165. View

11.

Lewis M, Bendersky M, KOONS A, Hegyi T, Hiatt I, Ostfeld B . Visitation to a neonatal intensive care unit. Pediatrics. 1991; 88(4):795-800. View

12.

Neu M, Laudenslager M, Robinson J . Coregulation in salivary cortisol during maternal holding of premature infants. Biol Res Nurs. 2008; 10(3):226-40. DOI: 10.1177/1099800408327789. View

13.

Cong X, Ludington-Hoe S, McCain G, Fu P . Kangaroo Care modifies preterm infant heart rate variability in response to heel stick pain: pilot study. Early Hum Dev. 2009; 85(9):561-7. PMC: 2742959. DOI: 10.1016/j.earlhumdev.2009.05.012. View

14.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009; 62(10):e1-34. DOI: 10.1016/j.jclinepi.2009.06.006. View

15.

Phillips R, Merritt T, Goldstein M, Deming D, Slater L, Angeles D . Prevention of postpartum smoking relapse in mothers of infants in the neonatal intensive care unit. J Perinatol. 2011; 32(5):374-80. PMC: 3343345. DOI: 10.1038/jp.2011.106. View

16.

Allen M, Cristofalo E, Kim C . Outcomes of preterm infants: morbidity replaces mortality. Clin Perinatol. 2011; 38(3):441-54. DOI: 10.1016/j.clp.2011.06.011. View

17.

Cong X, Cusson R, Walsh S, Hussain N, Ludington-Hoe S, Zhang D . Effects of skin-to-skin contact on autonomic pain responses in preterm infants. J Pain. 2012; 13(7):636-45. DOI: 10.1016/j.jpain.2012.02.008. View

18.

White-Traut R, Wink T, Minehart T, Holditch-Davis D . Frequency of Premature Infant Engagement and Disengagement Behaviors During Two Maternally Administered Interventions. Newborn Infant Nurs Rev. 2012; 12(3):124-131. PMC: 3438916. DOI: 10.1053/j.nainr.2012.06.005. View

19.

Dieterich C, Felice J, OSullivan E, Rasmussen K . Breastfeeding and health outcomes for the mother-infant dyad. Pediatr Clin North Am. 2012; 60(1):31-48. PMC: 3508512. DOI: 10.1016/j.pcl.2012.09.010. View

20.

Reynolds L, Duncan M, Smith G, Mathur A, Neil J, Inder T . Parental presence and holding in the neonatal intensive care unit and associations with early neurobehavior. J Perinatol. 2013; 33(8):636-41. PMC: 3700586. DOI: 10.1038/jp.2013.4. View