Maternal Psychosocial Distress, but Not Family Integrated Care in Neonatal Intensive Care Units, Is Associated with Child Development at 18 Months

Background/Objectives: Preterm birth, even for moderate or late preterm infants (MLPI), is associated with longer-term developmental challenges. Family Integrated Care (FICare) models of care, like Alberta FICare, aim to improve outcomes by integrating parents into neonatal care during hospitalization. This follow-up study examined the association between models of care (Alberta FICare vs standard care) and risk of child developmental delay at 18 months corrected age (CA) and explored the influences of maternal psychosocial distress. Methods: We assessed 257 mothers and 298 infants from a cluster randomized controlled trial conducted in ten Level II NICUs in Alberta, Canada. l Risk of developmental delay was assessed using the Ages and Stages Questionnaires 3rd Edition (ASQ-3), Ages and Stages Questionnaires: Social- Emotional 2nd Edition (ASQ:SE-2), and the Brief Infant and Toddler Social Emotional Assessment (BITSEA). Maternal psychosocial distress was assessed using self-reported measures of depressive symptoms, anxiety, parenting stress, and self-efficacy. Results: There was no association between model of care and risk of child developmental delay. Higher maternal parenting stress was associated with increased risk of developmental delay on the ASQ-3 and ASQ:SE-2, and BITSEA. Conclusions: Alberta FICare was not associated with decreased risk of child developmental delay at months CA. Maternal parenting stress significantly influenced risk of child developmental delay, suggesting that post-discharge family environment plays a more important role in the development of MLPI than interventions in hospital.