Effect of newborn hospitalization on family and child behavior: a 12-year follow-up study
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Päivi Rautava1, Liisa Lehtonen, Hans Helenius
1Department of Public Health, University of Turku, Turku, Finland.
Insights
A newborn's critical illness significantly impacts family functioning and child behavior for up to 12 years. However, hospitalization of low-risk infants does not lead to negative long-term outcomes for families or children.
Area of Science:
- Neonatal care
- Child psychology
- Family studies
Background:
- Neonatal intensive care units (NICUs) are crucial for critically ill newborns.
- Hospitalization can cause parental stress and affect family dynamics.
- Understanding long-term effects is vital for supporting affected families.
Purpose of the Study:
- To investigate the long-term effects of newborn critical illness and hospitalization on family functioning.
- To assess child behavior outcomes over 12 years post-discharge.
- To differentiate impacts based on medical risk levels.
Main Methods:
- A prospective cohort study followed 1294 deliveries, with 170 infants in neonatal units and 1112 controls.
- Risk and control groups were established based on medical risk and child disabilities at age 3.
- Data collected via follow-up examinations at 3 and 9 months, and 3 and 12 years, measuring parental well-being, family functioning, and child behavior.
Main Results:
- Families of critically ill newborns reported increased need for support and maladjustment in the first year.
- Child behavior problems were higher at 3 years for critically ill infants' families, but normalized by 12 years.
- Families with low-risk hospitalized infants showed no adverse effects compared to controls.
Conclusions:
- Critical newborn illness has lasting effects on family and child well-being.
- Hospitalization of low-risk newborns does not appear to cause negative long-term consequences.
- Findings offer reassurance to families experiencing early separation due to low-risk infant hospitalization.
Objective:
To study the effects of a critical illness and hospitalization of a newborn on family functioning and child behavior during the subsequent 12 years.
Methods:
With the use of a randomized stratified cluster sampling, a follow-up of 1443 pregnant women was started at early pregnancy. These pregnancies resulted in 1294 deliveries. A total of 170 infants were admitted to neonatal units and were classified according to their medical risk, and 1112 healthy-born infants were eligible for the control group. After excluding the children with disabilities at 3 years of age, 134 remained in the risk groups and 952 children remained in the control group. The follow-up examinations were performed at the ages of 3 and 9 months and at 3 and 12 years. The main outcome measures were parents' subjective well-being and adjustment to the child, family functioning, and child's behavioral problems.
Results:
The families with a critically ill newborn experienced more need for support and maladaptation during the first year after delivery. They reported more child behavior problems at 3 years, but no differences were found at 12 years of age. The families with a hospitalized, low-risk infant coped as well as the controls.
Conclusions:
A critical illness of a newborn had long-lasting effects on the family and child behavior. The hospitalization of a newborn with a low medical risk did not have any negative consequences on family or child behavior. This is encouraging for a large group of families that experience early separation from their newborn infant as a result of hospitalization.
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