Parent Mental Health Interventions in the NICU

Key Takeaways

• The review included 160 studies, 16,639 parents, and 85 meta-analysis estimates assessing anxiety, depression, stress, and trauma symptoms with validated self-report questionnaires.
• Anxiety improved with bonding interventions, family-centered care and education, and psychotherapy and emotional support, while stress and depression improved with different category-specific patterns.
• The authors concluded that lower-resource family-centered care and education approaches, along with psychotherapy and emotional support interventions, were among the NICU-based options associated with improvements across outcomes.

A JAMA Pediatrics systematic review and meta-analysis found that NICU-based parent mental health interventions were associated with lower anxiety, stress, and depression symptom scores across several categories. The synthesis included 160 studies involving 16,639 parents, with 85 estimates pooled in the meta-analysis. Across intervention categories, pooled findings showed reductions in anxiety, stress, and depression symptoms on validated self-report measures. Psychotherapy and emotional support showed the most consistent pattern of benefit across outcomes.

The review examined quantitative original studies of NICU interventions intended to support parental mental health, with at least one validated measurement obtained during infant admission. Investigators searched PubMed, Cochrane CENTRAL, Embase, CINAHL, and PsycINFO from 2010 through December 2024. PRISMA guidance informed data extraction and synthesis, and Joanna Briggs Institute tools were used for risk-of-bias assessment. Meta-analysis required preintervention and postintervention means and SDs plus a control group, and the pooled sample had a mean parent age of 30.2 years with 93.5% female participants. These criteria supported outcome-specific pooled findings across several intervention categories.

For anxiety, significant decreases were associated with bonding interventions, with Hedges g of -0.90 and a 95% CI from -1.50 to -0.30. Anxiety also declined with family-centered care and education, with Hedges g of -1.49 and a 95% CI from -2.80 to -0.19, and with psychotherapy and emotional support, with Hedges g of -1.66 and a 95% CI from -1.97 to -1.34. For stress, family-centered care and education had a Hedges g of -0.75, psychotherapy had -1.54, and meditation and holistic interventions had -0.65, each with confidence intervals excluding no effect. Depression was reduced with expressive and artistic therapies, with Hedges g of -0.36 and a 95% CI from -0.68 to -0.04, and with psychotherapy, with Hedges g of -0.95 and a 95% CI from -1.80 to -0.10. Psychotherapy and emotional support showed the broadest pattern of benefit across outcomes.

In this systematic review and meta-analysis, the authors concluded that several NICU-based options were associated with reductions in parent mental health symptoms. They highlighted lower-resource family-centered care and education approaches alongside psychotherapy and emotional support, which showed the most consistent benefits across outcomes. Within that scope, the findings were associated with lower anxiety, stress, and depression symptoms during NICU admission, with the most consistent pattern seen for psychotherapy and emotional support.