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Updated: Aug 16, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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A biopsychosocial model of NICU family adjustment and child development

Victoria A Grunberg1,2,3, Pamela A Geller4, Casey Hoffman5,6

  • 1Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA. vgrunberg@mgh.harvard.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|December 22, 2022
PubMed

Insights

Family adjustment after Neonatal Intensive Care Unit (NICU) discharge depends on infant medical severity, parental stress, couple dynamics, and family resources. Targeted interventions can improve NICU family outcomes.

Area of Science:

  • Neonatal Intensive Care Unit (NICU)
  • Family Psychology
  • Child Development

Background:

  • Infants in the Neonatal Intensive Care Unit (NICU) face developmental risks, and their parents experience emotional distress.
  • Factors influencing family adjustment and child development post-NICU discharge are not fully understood.
  • This study introduces the first biopsychosocial model to explain family adjustment after NICU discharge.

Purpose of the Study:

  • To develop and validate a biopsychosocial model explaining family adjustment after Neonatal Intensive Care Unit (NICU) discharge.
  • To identify key infant, parent, couple, and family factors impacting long-term outcomes.
  • To inform interventions aimed at improving the well-being of families with NICU graduates.

Main Methods:

  • Utilized a structural equation model based on the Double ABC-X Model.
  • Included 101 families from a Neonatal Follow-Up Program, discharged 1.5-2.5 years prior.
  • Collected data via validated and standardized assessments, and electronic medical records.

Main Results:

  • The biopsychosocial model demonstrated dynamic relationships among various factors.
  • Infant medical severity significantly influenced family adjustment and child development.
  • Parental posttraumatic stress, couple functioning, and family resources were critical predictors of outcomes.

Conclusions:

  • Parental posttraumatic stress and couple dynamics are crucial targets for intervention.
  • Improving parental perception of personal time and access to financial support can enhance family well-being.
  • Interventions addressing these factors are vital for improving overall NICU family outcomes.
Abstract

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