Factors influencing parental presence in neonatal units: A systematic review

Abstract

BACKGROUND

Parental presence in neonatal units (NUs) is essential for infant development and family well-being. A deeper understanding of the factors influencing parental presence is vital and will contribute to the development of targeted interventions and policies that enhance parental engagement in neonatal care, thereby improving outcomes for infants and their families.

AIM

To identify and analyze primary factors influencing parental involvement in their child’s care in a neonatal intensive care unit (NICU).

METHODS

A literature search was conducted using the PubMed, MEDLINE, and Cochrane Library for systematic reviews databases, with the following search terms: “parental presence neonatology”, “couplet care”, “zero separation neonatal care”, “family integrated care”, “couplet care intervention”, “mother-child separation”, “parents newborn togetherness”, “mother-baby care”, “closeness and separation NICU”, “mother-infant interaction NICU”, “kangaroo care”, “dyad mother-infant”, and “newborn integrated care”. The database search for this literature review began on December 10, 2024, with the final search conducted on April 10, 2025.

RESULTS

The literature search yielded 281 articles, out of which 23 were selected for a detailed review. The factors associated with parental presence in NUs were grouped into five main categories: Parents’ socio-demographic and cultural traits; the physical layout and care model of the NUs; the quality of parents’ relationships with the healthcare staff; their active involvement in neonatal care; and the newborn’s health status.

CONCLUSION

The identification of factors that affect parental presence in NUs is critical for developing effective strategies aimed at encouraging increased parental involvement and ultimately improving neonatal and family outcomes.

Keywords: Parental presence; Neonatal intensive care unit; Neonatology; Couplet care; Kangaroo care; Family-centered care; Parental involvement; Infant development; Zero separation

Core Tip: Parental involvement in neonatal units has a significant beneficial effect on infant development and family health. This review systematically highlights key determinants of parental presence, categorized according to socio-demographic and cultural aspects, unit physical layout, staff relationships, active parental participation, and infant health status. Recognition of these factors is essential for designing tailored interventions and improving policies to ensure optimal neonatal and family outcomes.