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Resiliency factors relevant to NICU parents’ emotional and relational health

Journal of Perinatology (2026)Cite this article

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Abstract

Objectives

Despite the stress of having a baby in a Neonatal Intensive Care Unit (NICU), factors that promote adjustment remain unclear. We examined which resiliency factors were associated with family adjustment across the NICU journey.

Study design

Parents with a baby in the NICU (≤2 weeks) completed surveys at three timepoints (during admission (N = 165); 1 month later (N = 85); 3 months later (N = 55)). Surveys included sociodemographics and validated measures of emotional distress, relational outcomes, and resiliency.

Results

Mixed models revealed that lower parental distress was associated with: (1) higher mindfulness; (2) more adaptive coping; (3) greater parental self-efficacy (only anxiety); and (4) increased parental time for themselves (only posttraumatic stress). Higher couple satisfaction was associated with more dyadic coping and social support. Stronger parent-child bonding was associated with greater parental self-efficacy.

Conclusion

Mindfulness and coping are important for parental distress. Building parental efficacy, encouraging self-care, and promoting shared coping and social support is important.

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Data availability

Data available upon reasonable request to corresponding author.

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Acknowledgements

We want to thank the parents who participated in this study and the staff in Newborn Medicine at Massachusetts General Hospital for their support of this study.

Author contributors

Dr. Grunberg conceptualized and designed the study, coordinated and supervised data collection, conducted analyses, drafted the initial manuscript, and critically reviewed and revised the manuscript. Ms. Vitcov, Ms. Belkin, Ms. Davis, and Mr. Van assisted with study design, collected data, and critically reviewed and revised the manuscript. Dr. Lerou helped coordinate and supervised data collection and critically reviewed and revised the manuscript. Dr. Vranceanu helped conceptualize and design the study and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Funding

VG is supported by a K23 award from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD110597). A-MV is supported by a K24 award from National Center for Complementary and Integrative Health (1K24AT011760-01).

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Author notes

  1. These authors contributed equally: Paul H. Lerou, Ana-Maria Vranceanu.

Authors and Affiliations

  1. Center for Health Outcomes and Interdisciplinary Research, Mass General Brigham, Boston, MA, USA

    Victoria A. Grunberg & Ana-Maria Vranceanu

  2. Harvard Medical School, Boston, MA, USA

    Victoria A. Grunberg, Paul H. Lerou & Ana-Maria Vranceanu

  3. Division of Newborn Medicine, Mass General Brigham, Boston, MA, USA

    Victoria A. Grunberg, Giselle G. Vitcov, Elise Belkin, Julia O. Davis, Eric Van & Paul H. Lerou

  4. University of Miami Miller School of Medicine, Miami, FL, USA

    Elise Belkin

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Correspondence to Victoria A. Grunberg.

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Grunberg, V.A., Vitcov, G.G., Belkin, E. et al. Resiliency factors relevant to NICU parents’ emotional and relational health. J Perinatol (2026). https://doi.org/10.1038/s41372-025-02556-y

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