A Scoping Review of Preventive and Treatment Interventions of Parental Psychological Distress in the NICU in the United States

Parents of premature infants in the Neonatal Intensive Care Unit (NICU) are at elevated risk of anxiety, depression, stress, and trauma, which may impair bonding and infant development. This scoping review synthesized preventive and treatment interventions designed to reduce parental psychological distress in the United States. Guided by PRISMA-ScR, systematic searches were conducted in PubMed, Scopus, MEDLINE, and PsycINFO. Eligible studies were those that examined interventions for parents of preterm infants (<37 weeks' gestation) initiated before, during, or within one year after NICU discharge. Excluded were studies limited to abstracts or qualitative designs; those not addressing parental depression, anxiety, post-traumatic stress disorder, or stress; and those involving congenital anomalies or conducted outside the United States. Eighteen studies met the inclusion criteria, including ten prevention-focused and seven treatment-focused studies. Eight reported significant reductions in distress, with cognitive behavioral therapy (CBT) and the Creating Opportunities for Parent Empowerment (COPE) program showing the strongest evidence. However, most interventions targeted mothers, highlighting underrepresentation of fathers. Overall, findings underscore the need for interventions that address both parents, include diverse populations, and evaluate participant engagement to improve clinical applicability.