Quality of Life of Parents of Premature Infants: A Systematic Review and Meta-Analysis

TL;DR

Parents of premature infants experience lower quality of life during hospitalization, but targeted support can help improve their well-being over time.

Contribution

Identifies modifiable factors affecting parental quality of life and highlights the importance of family-centered care for preterm infant parents.

Findings

Parental quality of life is lowest during neonatal intensive care unit hospitalization.

Modifiable factors include psychological distress, lack of preparedness, and inadequate social support.

Quality of life disparities between mothers and fathers decrease over time.

Abstract

What is the quality of life (QOL) of parents of premature infants, and what factors are associated with it?

In this systematic review and meta-analysis of 34 studies with 6617 parents of preterm infants and 8295 parents of full-term infants, parental QOL was lowest during neonatal intensive care unit hospitalization. Key modifiable factors associated with QOL included parental psychological distress, lack of preparedness, and inadequate social support; disparities between mothers and fathers were most pronounced during the immediate postpartum period but narrowed over time.

In this study, birth and hospitalization of a premature infant was associated with lower parental QOL, but a trajectory of recovery could be supported by targeted interventions for mothers and socioeconomically disadvantaged parents through family-centered care, psychological support, and sleep hygiene.

This systematic review and meta-analysis examines the quality of life among parents of preterm infants and identifies modifiable factors associated with parental quality of life in the postpartum period.

Quality of life (QOL) of parents following the birth of a premature infant is substantially affected, necessitating a comprehensive understanding of its determinants to guide effective interventions.

To systematically assess QOL among parents of premature infants and to identify modifiable factors associated with their well-being.

PubMed, CINAHL, and Embase were searched from inception to October 5, 2025.

Cross-sectional studies, longitudinal cohort studies, and randomized clinical trials reporting quantitative QOL data using validated instruments were included.

The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Meta-analysis was performed using random-effects models. All studies underwent qualitative synthesis and quality appraisal. Data were extracted and quality was assessed by 2 independent reviewers.

Meta-analysis was carried out on studies that used the World Health Organization QOL–Short Form (WHOQOL-BREF; range, 0-100, with higher scores indicating better QOL) and the 12-Item Short Form Health Survey (SF-12; mean score, 50, with higher scores indicating better QOL) to assess the QOL among parents of preterm children. Qualitative analysis was performed to compare QOL of parents following preterm and full-term births, fathers vs mothers, and by degree of prematurity. Modifiable factors associated with QOL were identified by synthesizing evidence from longitudinal cohort studies and randomized clinical trials.

A total of 34 studies, with 6617 parents of preterm children and 8295 parents of full-term children, were included. Meta-analysis of WHOQOL-BREF data (10 studies, 1147 parents of preterm children) showed pooled mean domain scores ranged from 63.63 (95% CI, 54.00-73.35) in the environmental domain to 66.68 (95% CI, 59.77-73.60) in the psychological well-being domain. Systematic review found that lower parental QOL was evident during infant hospitalization with improvement over time. Meta-analysis of SF-12 data (5 studies, 3137 parents) revealed pooled mean physical and mental component summary scores of 47.22 (95% CI, 40.06-54.39) and 44.58 (95% CI, 39.01-50.16), respectively. High heterogeneity reflected variability of infant maturity, assessment timing, and sociodemographic factors. Parents of preterm infants reported lower QOL than parents of full-term children in the early postpartum period, but this gap narrowed over time. Mothers reported poorer QOL compared with fathers during the infant’s hospitalization, but the gap diminished by 4 to 6 months post partum. Key modifiable factors of QOL were parental psychological well-being, knowledge and empowerment, social and systemic support, and infant-related health burdens.

In this systematic review and meta-analysis, parental QOL was lowest during the premature infant’s hospitalization. A family-centered approach, with timely and tailored support from the neonatal intensive care unit through the postdischarge period, is essential to protect and promote parental well-being.

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