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Effectiveness of Family Integrated Care for Preterm Infants and Their Parents in Neonatal Intensive Care Units: A
Ru-Lin Liu1, Sheng-Zhi Zhan1, Xiao-Ping Guo1
1Department of Neonatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China.
Insights
Family Integrated Care (FICare) enhances infant weight gain and reduces parental stress and anxiety in neonatal intensive care units (NICUs). Further high-quality trials are needed due to low certainty of evidence.
Area of Science:
- Neonatal care research
- Parental involvement in healthcare
- Clinical psychology in pediatrics
Background:
- Family Integrated Care (FICare) is a structured model for parental engagement in NICUs.
- While FICare aims to improve infant outcomes and parental well-being, its overall effectiveness is uncertain.
Purpose of the Study:
- To evaluate the effectiveness of FICare compared to standard NICU care for preterm infants and their parents.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
- Searches were performed across multiple databases including PubMed, Embase, and PsycINFO up to May 2025.
- Pooled risks and mean differences were calculated, with risk of bias assessed using Cochrane RoB 2.0.
Main Results:
- Eight RCTs were included in the analysis.
- FICare was associated with significantly greater infant weight gain (SMD=1.07) and reduced parental stress (MD=-0.30) and anxiety (MD=-2.36).
- No significant differences were found for breastfeeding, feeding duration, length of stay, or readmission rates.
Conclusions:
- FICare demonstrates benefits for neonatal growth and parental psychological outcomes.
- The current evidence has low certainty, necessitating cautious interpretation.
- Further high-quality research is recommended to confirm these findings and support wider implementation.
Background:
Family Integrated Care (FICare) is a structured model of parental participation in NICUs designed to improve infant outcomes and promote parental well-being. While some trials have shown benefits, effectiveness across clinical and psychosocial outcomes remains uncertain.
Aim:
To evaluate the effectiveness of FICare compared with standard neonatal intensive care unit (NICU) care in preterm infants and their parents.
Study Design:
PubMed, Embase, PsycINFO, Web of Science, Medline, CINAHL Complete and ClinicalTrials.gov were searched from inception to May 5, 2025. Eligible studies were randomised controlled trials (RCTs) comparing FICare with standard NICU care. Pooled relative risks (RRs) were calculated for categorical outcomes, and standardised mean differences (SMDs) or mean differences (MDs) for continuous outcomes. Risk of bias was assessed with the Cochrane RoB 2.0 tool, and sensitivity analyses tested the robustness of findings.
Results:
Eight trials were included. FICare was associated with greater weight gain (three studies; SMD = 1.07; 95% CI: 0.15-1.99; I2 = 98.9%) and reductions in parental stress (three studies; MD = -0.30; 95% CI: -0.53 to -0.07; I2 = 90.6%) and anxiety (two studies; MD = -2.36; 95% CI: -4.36 to -0.37; I2 = 58.4%). No significant differences were observed for breastfeeding, time to full enteral feeding, hospital stay, or readmission. Most studies had some concerns regarding bias, and sensitivity analyses confirmed robustness.
Conclusions:
FICare improves neonatal growth and parental psychological outcomes; however, the low certainty of evidence warrants cautious interpretation and highlights the need for further high-quality trials.
Relevance To Clinical Practice:
Implementing FICare in NICUs may improve infant growth and parental well-being, supporting broader adoption in neonatal care.
Trial Registration:
PROSPERO Registration number: CRD420251004003.
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