Interventions to support parents, families and caregivers in caring for preterm or low birth weight infants at home: A systematic review and meta-analysis

The aim of this study was to determine what interventions, approaches, or strategies to support mothers/fathers/caregivers and families in caring for preterm (<37 gestational weeks) or low birthweight (<2,500g) infants in the home have been effective in improving outcomes. We conducted a systematic review and meta-analysis. A comprehensive search of relevant electronic databases, including MEDLINE, Embase, CINAHL and Cochrane Central Register of Controlled Trials was completed in September 2024. Studies were included if they utilised interventions which focused on providing support to participants (mother/father/parents, families or caregivers) to care for their infants in the home. Two reviewers independently screened papers in Covidence and extracted data. Random effects meta-analyses were undertaken. Quality of studies and certainty of evidence were assessed using CASP and GRADE, respectively. Critical outcomes based on WHO preterm and low birthweight criteria comprised infant mortality, morbidity, growth and neurodevelopment. Priority outcomes comprised breastfeeding, care seeking, parent-infant interaction, mother-child attachment and parental health and wellbeing. Forty-seven studies were included. There is some evidence that support interventions may improve outcomes related to infant mortality, improvements in infant growth, exclusive breastfeeding, infant cognitive development, immunisation uptake, and reduction in maternal stress and depression. However, the overall certainty of evidence is low or very low in the majority of studies. We conclude that interventions providing support for parents to care for infants in the home may improve outcomes for this population. There is a need for well-considered large scale support interventions, prioritised and developed with women and families.