Impact of COVID-19 pandemic on parental presence and care participation in the NICU

Increased maternal participation in the care of the infant in the Neonatal Intensive Care Unit has been shown to improve neurodevelopment outcomes. We sought to determine the effect of restrictions on the frequency of visitation and care participation (holding or skin-to-skin care) of parents having government insurance compared to parents with private insurance. In a retrospective, observational cohort study, infants admitted to the NICU, born before the pandemic restrictions (09/06/2018 to 2/12/2020) in the unit were included in epoch 1, while those born during the restrictions (3/12/2020 to 11/10/2021) were in epoch 2. In each epoch, we compared the frequency of parental presence and duration of care participation of the groups of mothers with government insurance (GOI) to mothers with private insurance (PRI) between weeks 2–5 of admission of the neonate. 167 dyads met the inclusion criteria–84 in epoch 1 and 83 in epoch 2. No demographic differences between the epochs were found. There was a significant difference in the percentage of days parents were present between PRI and GOI in epoch 1 (89% vs. 68.8%, p < 0.01), but the difference in epoch 2 was not significant (83.9 vs. 73.4, p = 0.06). Similar results were found for care participation as well: epoch 1 (PRI = 54 vs. GOI = 18, p < 0.01) but not in epoch 2 (PRI = 36 vs. GOI = 24, p = 0.13). The study demonstrated a significant narrowing of the gap in parental presence and care participation between government and private insurance holder parents during the pandemic.