Early dyadic interventions for critically ill neonates: a scoping review

Early dyadic interventions improve parental mental health, infant development, and parent-infant relationships. We reviewed and synthesized existing research on early dyadic interventions with a neonatal intensive care unit (NICU) inpatient component, with an emphasis on psychotherapeutic approaches. We mapped the available evidence and identified gaps in the literature. Followed PRISMA-ScR reporting guidelines. Search engines used:PubMed, MEDLINE, MEDLINE Plus, EBSCO, Cochrane Central, Google Scholar, and Science.gov. Key search terms included “dyadic interventions in the NICU,” NICU dyadic health,” “attachment-focused interventions in NICU, ‘neonatal intensive care unit, “Early Relational interventions” and “relational interventions in the NICU.” English papers between 2014 and 2024. Feasibility, physical and/or mental health, and relational outcome measures were included. Nine of the 2331 papers reviewed met the inclusion criteria. Extracted author, year of publication, intervention type, study design, sample characteristics, location outcomes, mental health intervention, and the number of early dyadic interventions included. All early dyadic interventions improved parents’ mental health, infant neurodevelopment, and parent-infant relationships. We found substantial heterogeneity across included studies in terms of study design, sample characteristics, operationalization of dyadic intervention, and outcome measures. However, most interventions were not psychotherapy; more detailed research is needed to understand the long-term impact of early psychotherapeutic dyadic interventions. Infant and Early Childhood dyadic interventions have yet to be studied in the inpatient NICU setting. This highlights a critical need for research to study the feasibility and impact of infant mental health dyadic interventions for this vulnerable population in this setting.