Parental QoL plummets during preemie NICU admission

A systematic review and meta-analysis show that the admission of a premature infant (preemie) to the neonatal intensive care unit (NICU) takes a toll on the quality of life (QoL) of parents.

“[In this analysis, preemie parents] reported lower QoL than those of full-term children in the early postpartum period, but this gap narrowed over time,” the investigators noted. Additionally, mothers had poorer QoL than fathers during their infant’s hospitalization, but this also improved over time.

Thirty-four studies were included in the analysis. The studies included 6,617 parents of preemies (4,546 mums, 303 dads, 1,768 unspecified) and 8,295 parents of term children (3,593 mums, 1,106 dads, 3,596 unspecified). In most studies, QoL was evaluated within the first year postpartum. [JAMA Netw Open 2026;9:e2553712]

Ten studies (1,147 preemie parents) reporting QoL with WHOQoL-BREF* were meta-analysed. Across the four domains (physical health, psychological well-being, social relationships, and environmental), parental QoL was lowest during the immediate postpartum period and while the infant was in the NICU, with scores increasing over time. The pooled mean score was lowest in the environmental domain (63.63), followed by physical health (65.49), social relationships (66.26), and psychological health (66.68).

Across five studies (3,137 parents) using SF-12**, the pooled mean physical and mental component summary scores were 47.22 and 44.58, respectively.

Do mums have it worse?

Mums consistently reported poorer QoL during early evaluations (ie, at NICU admission, within the first month postpartum), but this waned over time. [J Neonatal Nurs 2022;28:407-412; Ital J Pediatr 2022;48:13; Indian Pediatr 2023;60:317-319; Matern Child Health J 2023;27:1719-1725; Sleep Sci Pract 2024;8:8] The researchers noted that this underlines the greater maternal vulnerability after childbirth.

In a study conducted in Lebanon during a period of social and economic crises, mums of preemies had significantly lower QoL across the physical, psychological, and social domains immediately after birth than mums of full-term infants. However, the gaps between groups diminished at 4–6 months postpartum. [AJOG Glob Rep 2025;5:100557]

Studies focusing on paternal QoL also showed that dads of preemies had higher anxiety rates and poorer QoL at 6 weeks postpartum than dads of full-term infants. [J Psychosom Obstet Gynaecol 2021;42:162-167] “However, current NICU parent support programmes are often focused on the mum, underestimating the unique needs of dads,” they pointed out.

“These findings underline the importance of gender-sensitive support – providing mums with emotional and physical help after birth and helping dads participate more in caregiving with appropriate psychosocial and emotional support … Future research should systematically recruit dads and examine dyadic coping processes to inform gender-sensitive interventions,” they said.

Key modifiable factors

The investigators identified four key modifiable factors: parental psychological and emotional stress; lack of knowledge, preparedness, and empowerment; insufficient social and systemic support; and infant-related health burdens.

According to the researchers, these factors could form the basis for interventions to support parental QoL, such as spiritual self-care training, web-based diaries, and peer/social support programmes.

Takeaways

“In this study, the birth and hospitalization of a preemie were associated with lower parental QoL, but a trajectory of recovery could be supported by targeted interventions for mums and socioeconomically disadvantaged parents through family-centred care, psychological support, and sleep hygiene,” the researchers said.

“We expect our review to assist healthcare practitioners in identifying parents of preemies who may be at risk of poorer QoL and to establish an evidence base to inform the development of targeted interventions and supportive policies to promote parental well-being,” they noted.