Digital health interventions for mothers and their high-risk neonates discharged from NICU: A systematic review and meta-analysis

Digital health technologies are crucial in neonatal care, aiding mothers in managing the health of neonates post-NICU discharge. These technologies help monitor and support medically complex neonates. This review examines mHealth interventions' impact on high-risk neonates' clinical outcomes and their mothers' psychological outcomes at post-NICU discharge. Seven databases were searched from 2011 to March 2024 using specific keywords. Rayyan software was used to screen the included studies, and RevMan 5.4 was used to perform meta-analysis. The quality of the included randomized controlled trials (RCTs) was assessed using the Cochrane Risk of Bias Tool (RoB-2), while the ROBINS-I tool was used for non-randomized studies. The search found 1164 articles; finally, 21 studies (16 RCTs, 5 non-RCTs) were included in data synthesis. Digital health strategies identified were mHealth, e-Health, telemedicine, phone reminders, and text messages. 10 studies in the narrative synthesis showed improved neonatal outcomes, such as growth, development, breastfeeding rates, immunization, and reduced readmission rates. Eleven studies in the meta-analysis indicated significant reductions in maternal stress and enhanced competence in neonatal care. However, maternal satisfaction did not differ significantly between groups. The review emphasizes the importance of training mothers in digital technology and implementing digital-oriented interventions to support mothers of high-risk neonates discharged from NICUs, particularly in low- and middle-income countries, for effective utilization of digital health interventions.