Association of parental holding during therapeutic hypothermia and NICU outcomes for infants with hypoxic-ischemic encephalopathy.

OBJECTIVE

To examine associations between parental holding during therapeutic hypothermia (TH) and neonatal intensive care unit (NICU) outcomes among infants with hypoxic-ischemic encephalopathy (HIE).

STUDY

DESIGN

Retrospective cohort of 379 infants with HIE at two level IV NICUs (2017-2024). Unadjusted and adjusted regression models evaluated associations between holding during TH and NICU outcomes.

RESULT: Overall, 28% of infants were held during TH. Holding was less common among infants with greater clinical severity, public insurance, or those identified as Hispanic, Asian, or Black. After adjustment for clinical and sociodemographic factors, holding was associated with faster time to full oral feeding (HR = 1.4, p < 0.01), earlier age at full oral feeding (HR = 1.6, p < 0.01), shorter hospitalization (β = -7.5, p = 0.02), and higher odds of breastmilk feeding at discharge (OR = 3.2, p = 0.03).

CONCLUSION

Parental holding during TH is associated with favorable short-term NICU outcomes, supporting its potential role as a family-centered care practice during neonatal neurocritical care.