Abstract
Background: Survival of very-low-birth-weight infants is improving in neonatology and family-centered-care might contribute to premature infants' clinical outcomes.Aim: To evaluate a family-centered care intervention on clinical outcomes of very-low-birth-weight infants.Methods: A quasi-experimental study was conducted in a Chinese NICU between June 2016 and June 2017. The intervention included parental education of basic care knowledge and skills followed by active participation in care for at least 4 h a day. A total of 319 very-low-birth-weight infants were recruited by convenience sampling; intervention group n = 156 and control group n = 163. Primary outcome measures were weight at discharge, length-of-stay, breastfeeding, nasal feeding, total parental nutrition, re-admission, hospital expenses. Secondary outcome measures were infant complications.Results: Infants' weight at discharge was higher in the interventions group (2,654 g vs. 2,325 g, p < 0.001). Nutritional outcomes improved significantly: breastfeeding rate 139 vs. 91, p < 0.001; days of total parental nutrition 25 d vs. 32 d, p < 0.001; gastric feeding days 23 d vs. 35 d, p < 0.001. Length-of-stay and hospital expenses did not differ between both groups. Improved infants' complications were bronchopulmonary dysplasia (32 vs. 51, p = 0.031), retinopathy of prematurity (between groups no/mild and moderate/severe, p = 0.003), necrotizing enterocolitis (6 vs. 18, p = 0.019), and re-admission rate (21 vs. 38, p = 0.023). No differences were observed in intraventricular hemorrhage and nosocomial infections.Conclusion: Very-low-birth-weight premature infants might experience improved clinical health outcomes when parents are present and caring from them. Family-centered care is as a beneficial care model for premature infants and should be recognized and implemented by NICUs where parents have currently limited access.
Highlights
It is estimated that 15 million preterm neonates are born every year worldwide [1]
Of the 524 very low birth weight (VLBW) infants admitted to the Neonatal Intensive Care Units (NICU) during the 12-month recruitment period. 319 met the inclusion criteria and were assigned to the Family-centered care (FCC) group (n = 156) or standard care group (n = 163)
The infants’ clinical outcome measures were promising in terms of infants’ weight and nutritional support while complication rates of Bronchopulmonary dysplasia (BPD), Retinopathy of prematurity (ROP) and Necrotizing enterocolitis (NEC) have been less in the FCC group
Summary
It is estimated that 15 million preterm neonates are born every year worldwide [1]. Preterm birth complications are the most frequent causes of deaths in children under 5 years of age [3, 4]. Preterm infants born with very low birth weight (VLBW) experience several disadvantages and developmental challenges [5,6,7]. A 20-year follow-up study identified that males born with VLBW were significantly shorter and lighter as their female counterpart at 20 years of age [8]. Advances in medical technology has increased survival rates in neonatology, morbidity remains high and imposes emotional and financial burdens on families, society and healthcare system. Survival of very-low-birth-weight infants is improving in neonatology and family-centered-care might contribute to premature infants’ clinical outcomes
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