A Pilot Randomized Controlled Trial of 24-h Webcam Access in the Neonatal Intensive Care Unit

Although interest is increasing, 24-h live-streaming webcams are rare in neonatal intensive care units (NICUs), underscoring the need for evidence to support their use. Therefore, we evaluated the effect of 24-h webcam access on parental anxiety, bonding, and postpartum depression in a NICU setting and examined the impact on the workflows of healthcare providers.

This study was conducted from April 2023 to March 2024 in a tertiary NICU in Japan, as a pilot randomized controlled trial designed to assess feasibility and estimate the potential effect size. Parents of infants expected to stay >1 month in the NICU were enrolled. Participants were randomized to receive 24-h webcam access or no webcam access (control). The primary outcome was the Mother-to-Infant Bonding Scale (MIBS) score at 1 month after birth. Secondary outcomes included the State-Trait Anxiety Inventory (STAI), Edinburgh Postnatal Depression Scale, salivary oxytocin levels, breastfeeding volume, and staff perceptions assessed birth and at 1 month.

Eighty parents of 41 infants were enrolled. MIBS scores did not differ significantly between groups (mothers: 2.4 ± 2.1 vs. 2.3 ± 1.8; fathers: 3.4 ± 2.8 vs. 4.2 ± 2.1). In contrast, STAI scores decreased significantly in the webcam group at 1 month (mothers: 48.0-37.3; fathers: 44.3-35.6; both p < 0.001), with a significant between-group difference (p < 0.05, difference-in-differences analysis). Staff surveys indicated that 92% of nurses supported webcam use, and no adverse events occurred.

Continuous 24-h webcam access reduced parental anxiety and was well accepted by staff and families. Larger multicenter studies are warranted to validate our findings.