Oral or Poster Presentation
Concurrent Session 2A - Neonatal Clinical Epidemiology
Introduction: Family Integrated Care (FICare) in Level III neonatal intensive care units (NICU) is feasible, safe, and improves outcomes for infants and mothers. We adapted FICare for Level II NICUs in Alberta and evaluated the effect on infant and maternal outcomes.
Methods: We stratified 10 Level II NICUs by size and randomly assigned sites to provide Alberta FICare©™ (n=5) or standard care (n=5). We enrolled mothers and their preterm singleton or twin infant(s) born between 320/7 and 346/7 weeks gestational age (GA) with a primary admission or transfer within 72 hours. At Alberta FICare©™ sites, we included mothers who committed to spending a minimum of 6 hours/day in NICU. Alberta FICare©™ is a psychoeducational intervention with three components: Relational Communication, Parent Education, and Parent Support. We used intention-to-treat, and compared outcomes between groups.
Results: Between December 15, 2015 and July 26, 2018, we enrolled 765 infants (543 singletons and 111 twin cases) and 654 mothers; 375 infants/325 mothers at Alberta FICare©™ sites and 390 infants/329 mothers at standard care sites. Compared to standard care, infants in Alberta FICare©™ had a shorter length of stay (LOS; 18.07 days [SD 8.33] vs 20.03 days [SD 8.22]). Compared to standard care, maternal psychosocial distress (anxiety, depressive symptoms, and stress) and self-efficacy in parenting and breastfeeding at discharge were better in the Alberta FICare©™ group. There were no differences between groups in breastmilk feeding at discharge or rates of hospital readmission and ED visits at 2 months corrected age.
Conclusion: Alberta FICare©™ reduced preterm infant LOS in Level II NICU and improved maternal psychosocial distress and self-efficacy. The results of this study are limited by a small number of sites in a single jurisdiction and inclusion of a select group of preterm infants.