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Updated: Jun 29, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Association of Very Low Birth Weight Infants With Parental and Sibling Mental Health Care Usage
Katherine E Schwartz1, Russell T Nye2,3, Susannah Colt4
1Division of Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, New Hyde Park.
Insights
Parents and siblings of premature infants used more mental health care. Bereaved families, especially parents, showed higher and prolonged needs, highlighting the importance of targeted support.
Area of Science:
- Neonatal Intensive Care
- Public Health
- Mental Health Services Research
Background:
- Families of very low birth weight (VLBW), premature infants face increased risks for mental health issues and higher healthcare utilization.
- Understanding mental health care use patterns in these families is crucial for developing effective interventions.
Purpose of the Study:
- To examine mental health care utilization patterns among parents and siblings of VLBW, premature infants.
- To identify specific needs within bereaved and non-bereaved families.
Main Methods:
- Retrospective cohort study using US commercial insurance claims data (July 2015–June 2016).
- Included VLBW (≤30 weeks' gestational age or <1500 g) neonates and matched control families.
- Analyzed mental health care usage in parents and siblings during the first year post-discharge.
Main Results:
- Case parents (VLBW infants) had higher mental health care use than controls.
- Bereaved case parents showed significantly increased use soon after infant death.
- Bereaved siblings had lower mental health care use than controls, while non-bereaved siblings and parents showed varied patterns over time.
Conclusions:
- Findings underscore the elevated and prolonged mental health care needs of parents and siblings of VLBW premature infants.
- Targeted interventions are necessary to address the unique mental health challenges faced by these families, particularly bereaved ones.
- Understanding these patterns can inform the development of supportive mental health services.
Background And Objectives:
Parents and siblings of very low birth weight, premature infants are at risk for poor mental health outcomes with increased mental health care usage. Knowledge regarding mental health care use patterns could guide interventions.
Methods:
This retrospective cohort study included US families with commercial insurance coverage from a single carrier. Neonates born at ≤30 weeks' gestational age or with a birth weight <1500 g were identified by insurance claim data between July 1, 2015, and June 30, 2016. Each case neonate family was matched with up to 4 control families.
Results:
The study included 1209 case and 1884 control neonates (with 134 deaths among only the case neonates [11.1% of cases]); 2003 case and 3336 control parents (mean [SD] age, 34.6 [5.4] years; 2858 [53.5%] female); and 884 case and 1878 control siblings (mean [SD] age, 6.8 [5.5] years; 1375 [49.8%] female). Compared with controls, more case parents used mental health care over the first year after birth hospitalization discharge. Higher usage was observed for bereaved case parents soon after their child's death. A smaller proportion of bereaved case siblings received mental health care compared with controls. Although nonbereaved case parents returned toward the proportion of use observed in controls, nonbereaved case female siblings, bereaved case female and male siblings, and bereaved male parents experienced continued differences.
Conclusions:
Understanding and meeting the mental health care needs of parents and siblings of very low birth weight premature neonates can be guided by these findings, including elevated and prolonged needs of bereaved parents and siblings.
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