IMPACT OF FAMILY-CENTERED CARE AND PARENTAL EDUCATION PROGRAMS IN NEONATAL UNITS ON INFANT OUTCOMES AND PARENTAL STRESS: A SYSTEMATIC REVIEW

Abstract Background: Family centered care (FCC) and structured parental education in neonatal intensive care units (NICUs) aim to improve infant outcomes and reduce parental stress. Contemporary FCC models typically combine parent training, coaching, mentorship, and opportunities for parents to participate in non-medical infant care. Evidence is growing but heterogeneous across settings and intervention designs. We aimed to synthesize evidence on the effects of NICU-based FCC and parental education programs on infant clinical outcomes and parental stress, psychological outcomes. Methods: We conducted a PRISMA-aligned systematic review of PubMed Central full-text original studies evaluating NICU FCC and, or parental education interventions with comparative designs (randomized, cluster randomized, or pre–post). Primary outcomes were parental stress and infant clinical outcomes. Risk of bias was assessed using RoB 2 for randomized trials and ROBINS-I for non-randomized studies. Where feasible, a random-effects meta-analysis was performed. Results: Ten original PMC studies were included (randomized, cluster randomized and quasi-experimental, pre–post). FCC, FIC approaches that increased parent presence and direct participation were associated with improved infant feeding and growth-related metrics and reduced respiratory support time in some studies. A pre–post FIC study in two Chinese children’s hospitals reported higher breastfeeding rates and weight gain and lower respiratory support time following implementation. Meta-analysis (2 studies) of parental stress outcomes showed substantial heterogeneity and no statistically significant pooled effect. Conclusion: NICU FCC and parental education programs, especially multi-component FIC models, may improve selected infant outcomes; effects on parental stress are inconsistent and highly heterogeneous. Future trials should standardize parental stress outcomes, report implementation fidelity, and evaluate longer-term infant and family outcomes.