Parental presence and holding in the neonatal intensive care unit and associations with early neurobehavior

L C Reynolds, M M Duncan, G C Smith, A Mathur, J Neil, T Inder, R G Pineda, L C Reynolds, M M Duncan, G C Smith, A Mathur, J Neil, T Inder, R G Pineda

Abstract

Objective: To investigate the effects of parental presence and infant holding in the neonatal intensive care unit (NICU) on neurobehavior at term equivalent.

Study design: Prospective cohort enrolled 81 infants born 30 weeks gestation. Nurses tracked parent visitation, holding and skin-to-skin care throughout the NICU hospitalization. At term, the NICU Network Neurobehavioral Scale was administered. Associations between visitation, holding and early neurobehavior were determined using linear and logistic regression.

Result: The mean hours per week of parent visitation was 21.33±20.88 (median=13.90; interquartile range 10.10 to 23.60). Infants were held an average of 2.29±1.47 days per week (median=2.00; interquartile range 1.20 to 3.10). Over the hospital stay, visitation hours decreased (P=0.01), while holding frequencies increased (P<0.001). More visitation was associated with better quality of movement (P=0.02), less arousal (P=0.01), less excitability (P=0.03), more lethargy (P=0.01) and more hypotonia (P<0.01). More holding was associated with improved quality of movement (P<0.01), less stress (P<0.01), less arousal (P=0.04) and less excitability (P<0.01).

Conclusion: Infants of caregivers who were visited and held more often in the NICU had differences in early neurobehavior by term equivalent, which supports the need for and importance of early parenting in the NICU.

Conflict of interest statement

There are no conflicts of interest to report.

Figures

Figure 1
Figure 1
Patterns of Visitation and Holding Across the Length of Stay Note: TE=Term equivalent age. The first time point in each plot represents the first two weeks of life; the second time point in each plot represents weeks three and four of life; the third time point represents week five through term-equivalent age; and the final time point represents a summary of what occurred from birth through term-equivalent.
Figure 1
Figure 1
Patterns of Visitation and Holding Across the Length of Stay Note: TE=Term equivalent age. The first time point in each plot represents the first two weeks of life; the second time point in each plot represents weeks three and four of life; the third time point represents week five through term-equivalent age; and the final time point represents a summary of what occurred from birth through term-equivalent.

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