Parent Mental Health Interventions in the NICU: A Systematic Review and Meta-Analysis.

Abstract

Poor parent mental health and elevated stress during neonatal intensive care unit (NICU) admission are linked to adverse parent and infant health longitudinally. To summarize recent literature on NICU-based interventions to support parent mental health and guide standards of care. A systematic data search was conducted of PubMed, Cochrane CENTRAL, Embase, CINAHL, and PsycINFO from 2010 to December 2024. Studies were included if they were (1) a quantitative original study, (2) had an intervention in the NICU to support parental mental health, (3) used a validated measure of parent mental health or stress to assess outcomes, and (4) had at least 1 measurement while the infant was admitted. For the meta-analysis, studies also needed to report preintervention and postintervention means and SDs and report a control group for comparison. Titles and abstracts, then full texts, were screened for inclusion criteria by 2 independent reviewers. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed for data extraction and synthesis, and Joanna Briggs Institute risk of bias tools were used. Study data were analyzed from February 2025 to January 2026. The primary outcomes were parent anxiety, depression, stress, and trauma symptoms captured by several validated self-report questionnaires. This analysis included 160 studies with 16 639 parents (mean [SD] age, 30.2 [5.8] years; 13 760 female [93.5%]) including 85 estimates for meta-analysis. Bonding interventions (Hedges g, -0.90; 95% CI, -1.50 to -0.30), family-centered care and education (Hedges g, -1.49; 95% CI, -2.80 to -0.19), and psychotherapy and emotional support (Hedges g, -1.66; 95% CI, -1.97 to -1.34) were associated with a significant decrease in parent anxiety. Family-centered care and education (Hedges g, -0.75; 95% CI, -1.30 to -0.21), psychotherapy (Hedges g, -1.54; 95% CI, -2.17 to -0.19), and meditation and holistic interventions (Hedges g, -0.65; 95% CI, -1.20 to -0.10) were associated with a significant reduction in parent stress. Expressive and artistic therapies (Hedges g, -0.36; 95% CI, -0.68 to -0.04) and psychotherapy (Hedges g, -0.95; 95% CI, -1.80 to -0.10) were associated with a significant reduction in parent depression. Results of this systematic review and meta-analysis suggest that, given several effective interventions to reduce parent mental health symptoms in the NICU, hospitals should consider implementing those that require few additional resources such as family-centered care and education and those that have the most consistent benefits across mental health outcomes, which were psychotherapy and emotional support interventions.