A Combined Care Model for Preterm Infants with Staged Family Involvement (A Single-Center Comparative Study with 3-Year Follow-Up)

D. Gao; T. Fan; C. Yan; Y. Tian; X. Liu; L. Zhang; H. Zi; A. A. Gusev; O. V. Komarova; M. A. Basargina; V. V. Chernikov; E. Yu. Dyakonova; F. Jiao

doi:10.46563/2026-1-2-2040

A Combined Care Model for Preterm Infants with Staged Family Involvement (A Single-Center Comparative Study with 3-Year Follow-Up)

https://doi.org/10.46563/2026-1-2-2040

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Abstract

Introduction. Family-centered and family-integrated care are increasingly regarded as important components of modern care for preterm infants. However, in Neonatal Intensive Care Units with traditionally closed policies, immediate implementation of continuous parental presence may be limited by organizational, infection-control, and staffing constraints. Therefore, evaluation of staged family involvement after clinical stabilization is of practical relevance.

Aim: to evaluate the clinical effectiveness of a combined care model including unaccompanied intensive care during the acute phase followed by staged parental participation in preterm infants.

Materials and methods. This single-center comparative study included 120 preterm infants admitted to the neonatal intensive care unit in 2021–2024. The study did not focus on a single nosological entity; rather, it evaluated a clinically heterogeneous cohort of preterm infants requiring treatment and care in the neonatal intensive care setting. The intervention group (n=60) received a combined model of unaccompanied care followed by staged family involvement, whereas the control group (n=60) received conventional unaccompanied care. Study measures included length of hospital stay, weight gain velocity, complications, breastfeeding at discharge, parental competence, parent-infant attachment, and age-appropriate growth/ development at 3 years. Parental competence and parent-infant attachment were assessed using local structured questionnaires with conversion of total scores to a 100-point scale. Mean differences (MD) and relative risks (RR) with 95% confidence intervals (95% CI) were additionally calculated.

Results. The combined model was associated with shorter hospitalization (29.8±5.6 vs 36.5±6.2 days; MD -6.70; 95% CI -8.84 to -4.56; p <0.001), higher weight gain velocity (19.5±3.1 vs 14.2±2.8 g/day; MD 5.30; 95% CI 4.23 to 6.37; p <0.001), lower complication rates (11.7% vs 28.3%; RR 0.41; 95% CI 0.18 to 0.92; p=0.022), and higher breastfeeding rates at discharge (81.7% vs 56.7%; RR 1.44; 95% CI 1.12 to 1.85; p=0.003). Parental competence, attachment, satisfaction, and the proportion of children with age-appropriate growth/development at 3 years were also higher in the intervention group.

Conclusion. A staged model combining controlled intensive care with family-integrated care may improve selected short-term hospital parameters and 3-year follow-up measures in preterm infants and can be considered a pragmatic pathway for Neonatal Intensive Care Units transitioning from closed policies to family-centered care.