Parental Presence and Holding in the Neonatal Intensive Care Unit and Associations with Early Neurobehavior

Abstract

Objective

To investigate the effects of parental presence and infant holding in the 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.

Results

The mean hours/week of parent visitation was 21.33±20.88 (median= 13.90; interquartile range 10.10–23.60). Infants were held an average of 2.29±1.47 days/week (median= 2.00; interquartile range 1.20–3.10). Over the admission, 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).

Interpretation

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