Single-family rooms vs. open-bay unit: new study reveals differences in psychological well-being of parents of very preterm babies depending on type of NICU design

In a study from Norway, researchers compared depression, anxiety, stress and attachment scores in parents of very preterm babies who were accommodated either in a single-family room (SFR) or in an open-bay (OB) unit.

Single-family room in the Children’s Hospital Dritter Orden Passau (c) Marcel Peda, pedagrafie

When a child is born preterm, parents often suffer from the immediate and lengthy separation from their babies in the hospital. As our instincts are programmed to take care of our offspring, separation in this early stage might result in distress and fear in parents who cannot be with their babies.

There are mainly two different models of accommodation: Single-family rooms (SFRs) are rooms in which the baby has a private room, enabling the parents to be with the baby 24 hours a day. SFRs are provided with all the necessary medical equipment and nursery care. In open-bay units, on the other hand, doctors and nurses care for many babies in a large room, typically separated only by curtains. If babies are hospitalised in open-bay units, parents spend much less time there and usually do not spend the night. However, previous studies suggested that SFRs might increase parental distress.

The researchers of this study have now investigated if SFRs do actually have a negative impact on the stress level of parents. For this purpose, they asked parents of very preterm babies hospitalised in either a SFR or an OB unit to fill in questionnaires. The survey was conducted in two Norwegian hospitals and 132 parents (mother and fathers) participated.

The main results of this study:

  • In SFRs, during the first week after birth, both parents were present on the average 20 hours per day. Parents in OB units, on the other hand, stayed only for a mean of 4 hours with their baby in the first week after birth.
  • When looking at a longer timeframe between birth and 34 weeks postmenstrual age (weeks counted from the first day of the last menstrual period), the study shows that parents with preterm babies in a SFR stayed for 21 hours (mothers) and 16 hours (fathers) on the average. Mothers and fathers in OB units spent time with their baby on the average for 7 and 5 hours respectively.
  • When compared to parents in the OB unit, parents in SFRs had a lower risk of depression and stress.
  • The increased participation of fathers in the SFRs from the day of birth was particularly surprising, as such a strong presence had never been reported before.
  • There were high scores on parental attachment in both groups.
  • There were no differences in stress and anxiety levels and attachment scores after discharge from the hospital between the SFR and the OB unit group.

The researchers conclude that the continuous presence of the parents in SFRs does not increase parental stress. At the contrary, the risk of depression and stress dropped in those parents who stayed with their babies most of the day and night. The researchers also suggest that the constant closeness of the parents may improve the health outcomes of the babies. The researchers therefore call for increased efforts to facilitate parental presence and participation in the NICU.

Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit
Tandberg BS, Flacking R, Markestad T, Grundt H, Moen A
PLoS One. 2019 Nov 5;14(11)