Evidenced-Based Recommendation for Involving Mothers to Reduce the Procedural Pain and Stress in High-Risk Neonates: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Neonates admitted to the neonatal intensive care unit (NICU) undergo several painful procedures, causing significant stress. Maternal involvement in neonatal care significantly reduces pain and stress, thereby supporting better neurodevelopment in neonates.

Clinical question: How do maternal involvement strategies reduce neonatal pain and pain-related stress in the NICU?

Data sources: A systematic search was conducted on CENTRAL, PubMed Medline, EMBASE, CINAHL, Scopus, Web of Science, ProQuest databases, and Google Scholar for studies published between January 2007 and March 2024.

Study selection: A search across 7 databases yielded a total of 1360 studies, which were exported to Rayyan software for screening. Two independent authors conducted the screening based on the eligibility criteria.

Data extraction: Cochrane data collection forms were used to extract the data from the included studies.

Results: Out of 1360 titles identified during the initial search, a total of 27 randomized controlled trials were eligible and were included. Although there is a slight inconsistency in results, meta-analysis findings revealed that skin-to-skin care, holding, massage, feeding the baby, and maternal voice stimulation, significantly reduce procedural pain and pain-related stress, in neonates admitted to the NICU.

Implications for practice and research: Given the consistent results, this systematic review strongly supports NICU healthcare professionals in encouraging mothers to engage in neonatal care activities to reduce procedural pain and related stress. More research is needed, including navigating the mothers on the importance of their involvement in neonatal care throughout the NICU admission and after hospital discharge.