63 - Characteristics of Paternal Presence in the Neonatal Intensive Care Unit

Publication Number: 4062.63

Janine P. Bernardo, Massachusetts General Hospital, Belmont, MA, United States; Sara Cherkerzian, Brigham and Women's Hospital, Boston, MA, United States; Wei He, Massachusetts General Hospital, Boston, MA, United States; Milton Kotelchuck, Harvard Medical School/MassGeneral Hospital for Children, Boston, MA, United States

Background: Parental involvement in the Neonatal Intensive Care Unit (NICU) encapsulates the earliest possible moments of father-child interaction and is beneficial to the family. More frequent presence of fathers to the NICU is associated with better growth and improved development among infants, as well as less stress and higher attachment among fathers. Yet, characteristics of paternal presence in the NICU are poorly described.

Objective: We seek to describe paternal visitation patterns (including frequency, timing, participation descriptors), associations between paternal visitation and infant and maternal characteristics, and paternal comparisons to maternal visitation.

Design/Methods: Retrospective analysis of paternal visitation patterns at a single, urban Level IV NICU from 1/1/17 - 12/31/23 for infants admitted ≥ 7 days. Median [IQR], for non-normal distributions and frequency (n) and percentage for continuous and categorical/binary variables, respectively. Differences in median percent days by demographic or clinical category tested using Wilcoxon Rank Sum or Kruskal-Wallis nonparametric tests.

Results: 1934 NICU newborns and 1783 mothers with ≥1 parental visit were included. Average gestational age (GA) was 34 weeks [IQR; 32-38] and birth weight was 2295 grams [IQR; 1600-3045] with an average length of stay (LOS) of 17 days [IQR; 10-35]. Mothers' average age was 33 [IQR; 30, 36], were mostly married (69.5%), commercially insured (68.8%), white (61.4%), and non-Hispanic (93.6%). 92.2% of infants had at least one paternal visit during the hospitalization, compared to 98.8% with at least one maternal visit. Fathers visited most often in the afternoon and for 30 minutes - 2 hours; compared with mothers, paternal visitation occurred later in the day and for shorter time periods. Fathers very actively participated in newborn care (Table 1). In bivariate analyses, higher GA, shorter LOS, maternal commercial insurance, primapara, white race, and married status were associated with more frequent visitation (Table 2).

Conclusion(s): Fathers are present often and are very interactive at the bedside, similar to mothers, although somewhat less frequently and less involved. Socio-demographics are associated with visitation frequency, especially by insurance status. Short term next steps include multivariable analyses to identify independent factors associated with visitation. More broadly, this is the first step of a multi-stage research study exploring father's viewpoints on visitation, including barriers and facilitators, to provide greater support of NICU fathers through desired and accessible interventions.

Table 1: Descriptors of paternal and maternal presence
Descriptors of paternal and maternal presence including frequency, timing, duration, participation, and behaviors.

Table 2: Bivariate comparisons of paternal and maternal presence
Comparisons of paternal and maternal presence based on neonatal and maternal characteristics.