Mothers who received care in the same room as their preterm infants had better mental health outcomes at discharge and were also more involved in the care of their infants compared to mothers whose infants received standard neonatal care with separate maternity care, according to a study reported in JAMA Network Open.¹

van Veenendaal undertook a prospective, multicenter study to examine the impact of family integrated care (FICare) model (one unit with single family rooms) on the mental health of mothers of preterm infants at the time of hospital discharge. The study group included 124 mothers. Another group of 115 mothers was selected whose infants received standard neonatal care in open bay units with separate care for the mothers. The study was conducted between May 2017 and January 2020 as part of the AMICA (fAMily Integrated CAre in the neonatal ward) study. The Parental Stress Scale: NICU (PSS-NICU) was used to assess maternal stress; high scores were indicative of higher stress levels. Maternal depression and anxiety, parenting self-efficacy and satisfaction with care were the secondary outcomes.

The overall stress regarding infant behavior, sights and sounds, change in parental role was lower in mothers in the FICare group as indicated by lower total PSS-NICU stress scores among mothers in the FICare group compared to mothers in the standard neonatal care group with adjusted mean difference of 12.24. Stress due to mother-newborn separation was also lower in the mothers in the FICare group (aMD 1.273). Extreme stress was reported by 34 mothers; of these, 24 were in the standard neonatal care group. About 84.7% mothers in the FICare group were present for at least 8 hours daily vis-à-vis 36.5% of mothers in the standard neonatal care group and participated more in the care of their infants.

Preterm births generally merit admission to NICU causing stress, anxiety and even depression in mothers. It also adversely affects mother-child bonding. This study has compared the stress levels and also the participation of mothers in the care of their preterm infants in family integrated care units versus standard neonatal care. Mothers in the FICare model who participated actively in neonatal care had lower stress levels at discharge; they were less likely to have depression and anxiety and bonded better with their infants. Strategies therefore should be planned around reducing the separation of mothers and their newborns as much as possible and encouraging them to participate more in neonatal care. The authors state “Active parent participation was a significant mediator of the association between the FICare model and less maternal depression and anxiety, higher maternal self-efficacy and better mother-newborn bonding”.

Reference

1. van Veenendaal NR, et al. Association of a zero-separation neonatal care model with stress in mothers of preterm infants. JAMA Netw Open. 2022 Mar 1;5(3):e224514. doi: 10.1001/jamanetworkopen.2022.4514.