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Breaking down barriers: enabling care-by-parent in neonatal intensive care units in China

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Abstract

Background

Denying parents access to their infant in the Neonatal Intensive Care Unit (NICU) is a standard practice in most hospitals across China. Visitation is not usually permitted or may be strictly limited, and NICU care for most neonates is provided by health-care professionals with little participation of the parents. An exception to this rule is the level 2 “Room-In” ward in Qilu Children’s Hospital, Shandong University, where parents have 24-hour access to their infants and participate in providing care.

Methods

This retrospective cohort study compared the outcomes of infants who were admitted to the NICU and remained there throughout their stay (NICU-NICU group, n=428), admitted to the NICU and then transferred to the Room-In ward (NICU-RIn group, n=1018), or admitted straight to the Room-In ward (RIn only group, n=629).

Results

There were no significant differences in the rates of nosocomial infection, bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity between the NICU-NICU and NICU-RIn groups. The rate of necrotizing enterocolitis was significantly lower in the NICU-RIn group (P=0.04), while weight gain and duration of hospital stay were significantly higher (both P<0.001). Rates of adverse outcomes were lower in RIn-only infants due to their low severity of illness on admission.

Conclusions

Allowing parents access to their infant in the NICU is feasible and safe in China, and may result in improvements in infant outcomes. Further studies are required to generate stronger evidence that can inform changes to neonatal care in China.

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Acknowledgements

We would like to thank the staff of the Canadian Neonatal Network Coordinating Centre, Toronto, Canada, for their assistance with the database and developing a data collection procedure. We would also like to thank the medical team in the Neonatology Department, Qilu Children’s Hospital Shandong University, Jinan, China for data collection.

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Authors and Affiliations

  1. Neonatalogy Department, Qilu Children’s Hospital Shandong University, Jinan, China

    Xiao-Ying Li, Hua-Feng Yu, Xiang-Hong Liu & Jian-Hong Liu

  2. Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada

    Shoo Lee, Xiang Y. Ye & Ruth Warre

  3. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada

    Shoo Lee

  4. No. 23976, Jingshi Road, Jinan, Shandong, China

    Jian-Hong Liu

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  1. Xiao-Ying Li
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Correspondence to Jian-Hong Liu.

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Li, XY., Lee, S., Yu, HF. et al. Breaking down barriers: enabling care-by-parent in neonatal intensive care units in China. World J Pediatr 13, 144–151 (2017). https://doi.org/10.1007/s12519-016-0072-4

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  • DOI: https://doi.org/10.1007/s12519-016-0072-4

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