Happiness for Improvement of Premature and Parental Outcome (HIPPO): determining parental stress during and directly after NICU admission (study protocol)

Aims: Premature infants admitted to a Neonatal Intensive Care Unit (NICU) are exposed to painful and stressful medical procedures with long-lasting effects. Former studies mainly focused on the effects of stress on the neonate; however, more extensive research on parental stress is necessary as this influences the parent child relation and outcomes of the child. Therefore, the national multicenter observational cohort ‘HIPPO study’ is initiated to better understand the role of parental stress during preterm birth, NICU admission, and after discharge. This abstract describes the ‘parental stress’ study protocol for the HIPPO study. Methods: Parents of preterm infants (aimed N = 400) born at a gestational age of \29 weeks and admitted to a Dutch NICU are eligible. All 10 NICUs will collect data for 12 months; start varied from July 2020 to March 2021. Parent couples are asked to complete Parent Reported Outcome Measures (ParROMs) using the KLIK PROM portal (www.hetklikt.nu) at three time points during and after NICU admission: 8–14 days after birth (T0), 28–34 days after birth (T1) and around expected due date (T2). Parents’ answers at T0 are being discussed with them by a NICU psychosocial staff member. Constructs measured are: Post Traumatic Stress Disorder (PCL-5), depression (PROMIS depression CAT), parental distress (Distress Thermometer for Parents) and NICU environmental stressors (PSS:NICU). Medical outcomes of the child and sociodemographic data are collected. Results: The main outcomes are: (1) Levels of PTSD, depression, and parental distress at T0, T1, and T2 and (2) associated variables are identified. We expect data inclusion to be completed in March 2022. Conclusion: This study provides insight into short-term parental consequences of preterm birth and NICU admission and sheds light on which parents should receive additional support during admission. Additional follow-up measurements at 6 (T3) and 12 (T4) months corrected age will be added for long term outcomes and parental outcomes will be related to child outcomes as well.