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Bourneuf AL, Pabic EL, de Visme S, Levieux K, Pladys P. Risk factors for unexpected infant death among very premature infants in France. Arch Pediatr 2024; 31:195-201. [PMID: 38538469 DOI: 10.1016/j.arcped.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/08/2023] [Accepted: 12/10/2023] [Indexed: 04/07/2024]
Abstract
BACKGROUND Prematurity is one of the risk factors for sudden unexpected infant death (SUID), a phenomenon that remains poorly explained. MATERIALS AND METHODS The analysis of specific factors associated with SUID among very premature infants (VPI) was performed through a retrospective review of data collected in the French SUID registry from May 2015 to December 2018. The factors associated with SUID among VPI were compared with those observed among full-term infants (FTI). Results are expressed as means (standard deviation [SD]) or medians (interquartile range [IQR)]. RESULTS During the study period, 719 cases of SUID were included in the registry, 36 (incidence: 0.60 ‰) of which involved VPI (gestational age: 29.2 [2] weeks, 1157 [364]) g] and 313 (0.18 ‰) involved FTI (gestational age: 40 [0.8] weeks, 3298 [452] g). The infants' postnatal age at the time of death was similar in the two groups: 15.5 (12.2-21.8) vs. 14.5 (7.1-23.4) weeks. We observed low breastfeeding rates and a high proportion of fathers with no occupation or unemployment status among the VPI compared to the FTI group (31% vs. 55 %, p = 0.01 and 32% vs. 13 %, p = 0.05, respectively). Among the VPI, only 52 % were in supine position, and 29 % were lying prone at the time of the SUID (compared to 63 % and 17 %, respectively, in the FTI group). CONCLUSION This study confirms prematurity as a risk factor for SUID with no difference in the SUID-specific risk factors studied except for breastfeeding and socioeconomic status of the fathers. VPI and FTI died at similar chronological ages with a high proportion of infants dying in prone position. These results argue for reinforcement of prevention strategies in cases of prematurity.
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Affiliation(s)
| | - Estelle Le Pabic
- CHU Rennes, Inserm, CIC 1414 (Clinical Investigation Center), F-35000 Rennes, France
| | | | - Karine Levieux
- Inserm CIC 1413, Nantes University Hospital, Nantes, France; Pediatric Emergency Care Unit, Nantes University Hospital, Nantes, France
| | - Patrick Pladys
- Department of Child and Adolescent Medicine, CHU de Rennes, Rennes, France; Research and Innovation Department, Paediatric Department, University Hospital of Rennes, Rennes, France
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Huang L, Zhao BY, Li XT, Huang SX, Chen TT, Cheng X, Li SJ, Li H, Hu RF. Effects of an online family-focused parenting support intervention on preterm infants' physical development and parents' sense of competence and care ability: A randomized controlled trial. Int J Nurs Stud 2024; 149:104625. [PMID: 37952471 DOI: 10.1016/j.ijnurstu.2023.104625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Parenting of preterm infants presents unique challenges, particularly during their transition from hospital to home. Early discharge programs can assist parents during this critical period. However, the feasibility of delivering a family-focused online discharge program remains understudied. OBJECTIVES This study was conducted to investigate the impact of a family-focused online parenting support intervention on parents' sense of competence, depression, caregiving, social support, family functioning, and the weight and length of preterm infants. METHODS We conducted a single-blind, two-arm randomized controlled trial with a repeated-measures design. Participants were recruited from a specialized tertiary hospital in China between May and December 2022. Forty-five families were randomly assigned to the intervention group and 44 to the control group. The intervention included three components: (1) two one-hour group sessions and three 30-minute individual sessions of online parenting support; (2) two follow-up telephone calls (15-30 min each) post-discharge; and (3) access to online parenting resources. Primary outcomes included parenting sense of competence, parental care ability, and preterm infants' weight and length. Secondary outcomes included depression, social support, and family functioning. Measurements were taken at baseline, preterm infant discharge, one month post-discharge, and three months post-discharge. A generalized estimating equation model was employed based on the intention-to-treat principle for outcome comparison. RESULTS Parents in the intervention group showed significant improvements in parenting sense of competence (P < 0.001), parental care ability (P < 0.001), depression (P < 0.001), and social support (P = 0.002). However, no statistically significant differences were observed in preterm infants' weight and length, or in family functioning (P > 0.05). CONCLUSIONS Although the intervention did not affect preterm infants' outcomes, the positive enhancements in parenting sense of competence, care ability, depression, and social support indicate that online family-focused parenting support can effectively prepare parents for hospital discharge and the early transition period.
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Affiliation(s)
- Long Huang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Bing-Yue Zhao
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiao-Ting Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Shui-Xiu Huang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Ting-Ting Chen
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiao Cheng
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Si-Jia Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hao Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rong-Fang Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China.
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Implementation Outcomes and Challenges of Partnerships between Resource Parents and Parents with Sick Infants in Intensive Neonatal Care Units: A Scoping Review. CHILDREN 2022; 9:children9081112. [PMID: 35892615 PMCID: PMC9331213 DOI: 10.3390/children9081112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/11/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022]
Abstract
Parents with a sick child in a neonatal intensive care unit (NICU) usually experience stress, anxiety, and vulnerability. These precarious feelings can affect early parent–child interactions and have consequences for the child’s neurodevelopment. Parents who have had a sick child in an NICU (veteran parents) can offer helpful interventions for these vulnerable families. This article is a scoping review of parental interventions used with the families of NICU infants, and an overview of French perspectives. Two independent reviewers studied the scientific literature published in English between 2001 to 2021 using Covidence software. The databases used were MEDLINE, ISI Web of Science, the Cochrane Database, and Google Scholar. Themes were identified from the articles’ results using an open coding approach. The data are presented in a narrative format. Ten articles were included, and four major themes addressed: (1) description of activities, (2) recommendations, (3) impact, and (4) barriers (resulting from recruitment, training, remuneration, and organization). Activities were very diverse, and a step-by-step implementation was recommended by all authors. Peer-support interventions might be a potential resource for those anxious parents and improve their NICU experiences. These challenges are described by SOS Préma in France. This article brings together recent studies on partnership in the NICU. It is an innovative topic in neonatology with vast issues to explore.
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Bonnot Fazio S, Dany L, Dahan S, Tosello B. Communication, information, and the parent–caregiver relationship in neonatal intensive care units: A review of the literature. Arch Pediatr 2022; 29:331-339. [DOI: 10.1016/j.arcped.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 12/15/2021] [Accepted: 05/12/2022] [Indexed: 11/30/2022]
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Schuetz Haemmerli N, Stoffel L, Schmitt KU, Khan J, Humpl T, Nelle M, Cignacco E. Enhancing Parents' Well-Being after Preterm Birth-A Qualitative Evaluation of the "Transition to Home" Model of Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074309. [PMID: 35409993 PMCID: PMC8998674 DOI: 10.3390/ijerph19074309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 01/03/2023]
Abstract
There are few programs available aimed at preventing short- and long-term negative consequences after preterm birth and covering the entire care continuum. The “Transition to Home (TtH)” model is such a program, offering structured, individual support for families with preterm infants before and after hospital discharge. This study gathers and examines the parents’ views of receiving support from an interprofessional team under the TtH model of care during hospitalization and after discharge. Using a qualitative explorative design, 39 semi-structured interviews with parents were analyzed thematically. From this analysis, three main themes were identified: (1) TtH and the relevance of continuity of care; (2) Enhancement of parents’ autonomy and self-confidence; (3) Perception of interprofessional collaboration. Within these themes, the most relevant aspects identified were continuity of care and the appointment of a designated health care professional to anchor the entire care continuum. Emotional support complemented by non-medical approaches, along with strength-based and family resource-oriented communication, also emerged as key aspects. Continuous, family-centered care and well-organized interprofessional collaboration promote the well-being of the family after a premature birth. If the aspects identified in this study are applied, the transition from hospital to home will be smoothened for the benefit of affected families.
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Affiliation(s)
- Natascha Schuetz Haemmerli
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
- Correspondence:
| | - Liliane Stoffel
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Kai-Uwe Schmitt
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
- Insel Gruppe, Bern University Hospital, 3010 Bern, Switzerland
| | - Jeannine Khan
- Kantonale Schule für Berufsbildung, 5001 Aarau, Switzerland;
| | - Tilman Humpl
- Tilman Humpl, Department of Paediatrics, St. Elisabethen-Krankenhaus, Kliniken des Landeskreises Lörrach, 79539 Lörrach, Germany;
| | - Mathias Nelle
- Mathias Nelle, Children’s Hospital, Kreiskliniken Böblingen, 71302 Böblingen, Germany;
| | - Eva Cignacco
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
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Pirrello J, Sorin G, Dahan S, Michel F, Dany L, Tosello B. Analysis of communication and logistic processes in neonatal intensive care unit. BMC Pediatr 2022; 22:137. [PMID: 35291967 PMCID: PMC8922841 DOI: 10.1186/s12887-022-03209-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In neonatology, parents play a central role as guarantors of the new-born's autonomy. Notifying parents about their infant's status in neonatal critical care is an integral part of the care. However, conveying this information can be very difficult for physicians and the neonatal medical team. The objective of this work is to assess the dimensions and dynamic processes of critical care communications in neonatal intensive care in order to enhance the development of theoretical and applied knowledge of these discussions. METHODS This qualitative, descriptive study was conducted on critical care new-borns less than 28 days-old who were hospitalized in a neonatal intensive care unit. Verbatim communications with the parents were recorded using a dictaphone. RESULTS The verbatim information had five themes: (a) critical care, (b) establishing the doctor-patient relationship, (c) assistance in decision making, (d) Socio-affective and (e) socio-symbolic dimensions. Our recordings underscored both the necessity of communication skills and the obligation to communicate effectively. Analysis of the dynamics of the communication process, according to the categories of delivering difficult information, showed few significant differences. CONCLUSION Physician training needs to include how to effectively communicate to parents to optimize their participation and cooperation in managing their care.
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Affiliation(s)
- J Pirrello
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.,Department of Neonatal Medicine, North Hospital, Assistance-Publique des Hôpitaux de Marseille, 13015, Marseille, France
| | - G Sorin
- Department of Neonatal Medicine, North Hospital, Assistance-Publique des Hôpitaux de Marseille, 13015, Marseille, France
| | - S Dahan
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
| | - F Michel
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.,Pediatric Intensive Care Unit, Hôpital de la Timone, Assistance-Publique des Hôpitaux de Marseille, 13005, Marseille, France
| | - L Dany
- Aix Marseille University, LPS, Aix-en-Provence, France.,Service of Medical Oncology, Hôpital de la Timone, Assistance-Publique des Hôpitaux de Marseille, 13005, Marseille, France
| | - B Tosello
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France. .,Department of Neonatal Medicine, North Hospital, Assistance-Publique des Hôpitaux de Marseille, 13015, Marseille, France.
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Losbar JL, Montjaux N, Ehlinger V, Germany L, Arnaud C, Tscherning C. Early discharge and hospital-assisted home care is associated with better neurodevelopmental outcome in preterm infants. Early Hum Dev 2021; 161:105451. [PMID: 34507020 DOI: 10.1016/j.earlhumdev.2021.105451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/24/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022]
Abstract
AIMS To compare hospital-assisted neonatal home care and standard hospital care for preterm newborns on neurodevelopment at 2 years corrected age, as well as duration of hospitalization, breastmilk rates, and readmissions before 1 year. METHODS This observational study enrolled 415 inborn neonates <34+ 6 weeks that received home care (2008 to 2015) in the French University Hospital of Toulouse and 3186 neonates from the national cohort of infants discharged in 2011 that received standard hospital neonatal care (EPIPAGE 2). Neurodevelopment at 2 years was assessed with the Ages and Stages Questionnaire-3 (ASQ-3). RESULTS At two years corrected age, infants in home care had 61% less risk of overall low ASQ ≤220 (OR = 0.4 [0.3-0.5], p < 0.001) and 31-80% less risk of low scores in four out of five domains compared to standard care. Home care was associated with shorter hospital stays (- 9 days; p < 0.001), higher breastmilk rates at final discharge (OR = 3.6 [2.8-4.6], p < 0.001 for singletons and OR = 2.3 [1.6-3.1], p < 0.001 for multiples), and more breastmilk feeding for at least six months (OR = 1.8 [1.3-2.3], p < 0.001 for singletons, OR = 3.6 [2.1-6.3], p < 0.001 for multiples). Readmissions also occurred less frequently with home care than with standard care, except for twins (OR = 0.7 [0.6-0.8], p < 0.001). CONCLUSION Hospital-assisted neonatal home care for preterm infants was associated with better neurodevelopment at 2 years corrected age, shorter duration of hospitalization, and higher rates of breastmilk feeding at 6 months.
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Affiliation(s)
| | - Nathalie Montjaux
- Department of Neonatal Medicine, Children's Hospital, Toulouse, France
| | - Virginie Ehlinger
- Center for Epidemiology and Research in POPulation health (CERPOP), Toulouse University, Inserm, UPS, Toulouse, France
| | - Laurence Germany
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), F-94807, Villejuif, France
| | - Catherine Arnaud
- Center for Epidemiology and Research in POPulation health (CERPOP), Toulouse University, Inserm, UPS, Toulouse, France; Clinical Epidemiology Unit, Toulouse University Hospital, Toulouse, France
| | - Charlotte Tscherning
- Université de Toulouse III, Toulouse, France; Division of Neonatology, Sidra Medecine, Weill Cornell Medical College, Doha, Qatar; Centre of Physiopathology Toulouse-Purpan (CPTP), Inserm, CNRS, University of Toulouse, France
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