Background: Supportive and targeted interventions for families are required to optimize parental adjustment and the parent-infant relationship in line with earlier diagnosis of neurodevelopmental risk for infants. Aims: The purpose of this systematic review was to determine the efficacy of interventions in improving psychological adjustment and well-being for parents who have an infant diagnosed with or at risk of neurodevelopmental disability. Methods: The Cochrane Review Group search strategy was followed with search of The Cochrane Central Register of Controlled Trials, PubMed, CINAHL, PsycINFO, and Embase between July and December 2017. Methodological quality of included articles was assessed using the Physiotherapy Evidence Database (PEDro) Scale by two independent reviewers. Results: Twelve studies met the inclusion criteria. A small number of highquality trials demonstrated moderate to large effectiveness of reducing adverse parent psychological symptoms of trauma and stress. Significant improvements in depression and anxiety symptoms emerged at longer-term (6 months to 8 years) follow-up postinterventions. Conclusions: There is promising support for the effectiveness of some interventions to reduce maladaptive psychological symptoms in parents with infants diagnosed at risk of neurodevelopmental disability. Further quality RCTs of psychological interventions addressing broader neurodevelopmental risk conditions for infants are required. K E Y W O R D S adjustment, infant, interventions, neurodevelopment, parent, psychology 1 BACKGROUND Parents of infants born with health complications and diagnosis of long-term risk of neurodevelopmental impairment experience varied adjustment challenges. The pregnancy and postnatal period is a heightened time of risk for parent mental health conditions, such as depression and anxiety (Howard et al., 2014). Parental mental health problems during infancy put the child at risk for detrimental long-term outcomes (Goodman et al., 2011; Hay et al., 2001). Infants of depressed mothers have been shown to have a range of adverse events including reduced play
These findings suggest that the etiology of postneonatal mortality is heterogeneous, with significant complexity in attributing specific causes of death and making designations of "preventability." The vast majority of infants who died of prematurity-related postneonatal causes never left the hospital, and only a small percentage of all infants that left the hospital before death were identified as being at high medical risk. Therefore, strategies for further decreasing postneonatal mortality must link high-risk follow-up programs to more comprehensive strategies that address risk throughout pregnancy and early childhood.
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