Pilot Implementation of the NeuroSense PremmieEd Parenting Educational Programme for Parents with Infants in the Neonatal Intensive Care Unit: A Sequential Cohort Design.

Introduction

Preterm birth and neonatal intensive care unit (NICU) admission may elevate parental stress and impair early parent-infant interaction. In low-resource settings, where staff and resources are limited, parental education programmes are often also limited, further complicating care engagement. This study piloted the NeuroSense PremmieEd parenting educational programme to assess its preliminary impact on maternal stress and knowledge in a South African public-sector NICU.

Objectives

This study aimed to pilot a contextually relevant parenting education intervention to enhance parental understanding of preterm infant behaviour, strengthen parents' capacity to interpret and respond sensitively to infant cues, and reduce parental stress during NICU admission. Methodology: This sequential cohort pilot study involved 60 mothers of preterm infants (gestational age, 24-36 weeks) admitted to two comparable NICUs. Mothers (aged 18-45 years) were allocated to three groups. Arm 1 received standard care (n = 20), Arm 2 received a printed educational booklet (n = 20), and Arm 3 received the booklet plus a facilitated education session (n = 20). Pre- and post-intervention data were collected using the Knowledge of Preterm Infant Behaviour (KPIB) questionnaire and the Parental Stressor Scale: NICU (PSS:NICU). Descriptive statistics were used to explore differences between arms.

Results

Knowledge scores measured with the KPIB tool showed a positive trend in all groups, with the greatest improvement observed in Arm 3; however, these changes were not statistically significant (p = 0.176). Maternal stress measured using the PSS:NICU increased significantly over time across all groups (F(1, 57) = 8.40, p = 0.005), with Arm 3 consistently reporting the lowest stress at both timepoints. Discussion: The facilitated intervention was associated with a trend towards improved maternal knowledge of preterm infant behaviour. This pilot study highlighted the potential of structured and culturally relevant education to support early parenting in a public-sector NICU in South Africa. Maternal stress levels remained high across all groups. While this finding may be due to parents' experience of changes in infant medical condition, fatigue, and other factors, these were not investigated in this study and therefore warrant further exploration in future work.

Conclusions

The NeuroSense PremmieEd programme shows promise in improving maternal understanding of preterm infant behaviour. The results highlight the need for further adaptation of content delivery, inclusion of diverse populations (e.g., by preterm category) and scalable, low-resource approaches to improve engagement and long-term outcomes.