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Improving outcomes for preterm infants: Mitigating stress exposure

Marliese Dion Nist1, Nicole Cistone1, Rita H Pickler1

  • 1Martha S. Pitzer Center for Women, Children, and Youth, College of Nursing, The Ohio State University, 1577 Neil Avenue, Columbus, OH, 43210, USA.

Seminars in Perinatology
|September 20, 2025
PubMed

Insights

Neonatal intensive care unit (NICU) stress from routine care and parental separation impacts preterm infant brain development. Interventions are needed to mitigate these common, yet overlooked, exposures and improve long-term outcomes.

Area of Science:

  • Neonatal neuroscience
  • Developmental psychology
  • Pediatric critical care

Background:

  • Neonatal intensive care unit (NICU) hospitalization exposes preterm infants to ubiquitous stress during critical brain development.
  • Immature brains are sensitive to environmental exposures, but NICU experiences often mismatch neurologic expectations.
  • This mismatch can lead to abnormal brain development and stress response programming.

Purpose of the Study:

  • To provide an overview of the effects of routine nursing care and parental separation on preterm infants.
  • To identify these as persistent NICU stressors impacting infant well-being.
  • To offer recommendations for interventions to mitigate negative effects.

Main Methods:

  • Literature review and synthesis of existing research on NICU stressors.
  • Analysis of the impact of routine nursing care on infant stress.
  • Examination of the effects of parental separation on infant stress.

Main Results:

  • Routine nursing care and parental separation are significant, often overlooked, sources of stress for preterm infants.
  • These experiences contribute to abnormal brain development and stress system programming.
  • Interventions targeting caregiving practices and parental presence can mitigate stress.

Conclusions:

  • Understanding the specific contributions of nursing care and parental separation is crucial for developing effective interventions.
  • Nurses and care providers can implement changes to reduce the stress burden on preterm infants.
  • System-level changes are recommended to optimize the NICU environment for better infant outcomes.

Keywords:
HospitalizationInfant, prematureIntensive care units, neonatalParents

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