Effectiveness of eHealth interventions for parents of preterm infants during transition from neonatal intensive care unit-to-home: A systematic review and meta-analysis.

BACKGROUND

Early intervention programmes increasingly use eHealth components to extend family-centred support beyond neonatal intensive care unit discharge. However, their effectiveness on parental and infant health outcomes during the transition from neonatal intensive care unit to home remains unclear.

OBJECTIVE

To assess the effectiveness of eHealth early intervention programmes supporting parents of preterm infants during the transition from neonatal intensive care unit to home on parental and infant outcomes.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES: Medical Literature Analysis and Retrieval System Online (PubMed), Cumulative Index to Nursing and Allied Health Literature (EBSCOhost), Psychological Information Database (ProQuest), Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials (CENTRAL; EBSCOhost), and ClinicalTrials (clinicaltrials.gov) from inception to 20 May 2024, supplemented by grey literature.

REVIEW

METHODS

Eligible randomised controlled trials evaluated eHealth-supported early intervention programmes initiated during neonatal intensive care hospitalisation or shortly after discharge and continuing into the post-discharge period. Random-effects meta-analyses were conducted when at least two trials reported comparable outcomes. Continuous outcomes were pooled using standardised mean differences with 95% confidence intervals.

RESULTS

Seventeen randomised controlled trials involving 2364 parent-infant dyads were included. Pooled analyses favoured eHealth-supported early intervention programmes for depressive symptoms at three months compared with usual care (standardised mean difference -0.25; 95% confidence interval -0.43 to -0.08). For parental stress, point estimates at three and six months favoured eHealth-supported programmes, although confidence intervals crossed the null value. Point estimates for anxiety and parenting competence or self-efficacy also generally favoured eHealth-supported programmes, but estimates were imprecise and uncertainty remained. Breastfeeding-related outcomes were mixed and could not be pooled. Infant developmental and health service utilisation outcomes were reported in few trials, were heterogeneous, and precluded quantitative synthesis.

CONCLUSION

eHealth early intervention programmes may provide small incremental benefits for parental outcomes during the neonatal intensive care unit-to-home transition, particularly in reducing depressive symptoms at three months. Effects on stress, anxiety, and parenting competence or self-efficacy remain uncertain, and evidence for infant outcomes is limited. These findings support the potential role of eHealth as a structured extension of nurse-led and interdisciplinary transitional care, but further robust evaluation is required to clarify effectiveness, equity, implementation, and sustainability.

REGISTRATION: PROSPERO CRD42023444721, registered 23 July 2023 and published previously (protocol publication blinded for peer review).

SOCIAL MEDIA ABSTRACT: eHealth-supported early intervention may benefit parental wellbeing after Neonatal Intensive Care Unit discharge, particularly for depressive symptoms.