4.7 Article

The Stockholm Neonatal Family Centered Care Study: Effects on Length of Stay and Infant Morbidity

Journal

PEDIATRICS
Volume 125, Issue 2, Pages E278-E285

Publisher

AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2009-1511

Keywords

parental involvement; preterm; length of stay; morbidity; family centered care

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Funding

  1. Vardal Foundation and Stiftelsen Samariten

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OBJECTIVE: Parental involvement in the care of preterm infants in NICUs is becoming increasingly common, but little is known about its effect on infants' length of hospital stay and infant morbidity. Our goal was to evaluate the effect of a new model of family care (FC) in a level 2 NICU, where parents could stay 24 hours/day from admission to discharge. METHODS: A randomized, controlled trial was conducted in 2 NICUs (both level 2), including a standard care (SC) ward and an FC ward, where parents could stay from infant admission to discharge. In total, 366 infants born before 370/7 weeks of gestation were randomly assigned to FC or SC on admission. The primary outcome was total length of hospital stay, and the secondary outcome was short-term infant morbidity. The analyses were adjusted for maternal ethnic background, gestational age, and hospital site. RESULTS: Total length of hospital stay was reduced by 5.3 days: from a mean of 32.8 days (95% confidence interval [CI]: 29.6-35.9) in SC to 27.4 days (95% CI: 23.2-31.7) in FC (P = .05). This difference was mainly related to the period of intensive care. No statistical differences were observed in infant morbidity, except for a reduced risk of moderate-to-severe bronchopulmonary dysplasia: 1.6% in the FC group compared with 6.0% in the SC group (adjusted odds ratio: 0.18 [95% CI: 0.04-0.8]). CONCLUSIONS: Providing facilities for parents to stay in the neonatal unit from admission to dischargemayreduce the total length of stay for infants born prematurely. The reduced risk of moderate-to-severe bronchopulmonary dysplasia needs additional investigation. Pediatrics 2010; 125: e278-e285

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