{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:07:49Z","timestamp":1783940869330,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":193,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP24K13307"],"award-info":[{"award-number":["JP24K13307"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate the impact of different restriction measures on parental presence and activities in a neonatal intensive care unit (NICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study was conducted in a level IV NICU in Japan between February 2021 and October 2023. The study included preterm infants born at &lt;\u200935\u2009weeks of gestation. Study groups included three different restriction measures: R1, only parents could visit the NICU between 9 a.m. and 3 p.m.; R2, grandparents and parents were allowed; and R3, visiting hours were extended to between 7 a.m. and 9 p.m. Primary outcomes were duration of parental presence (minutes per visit) and visiting frequency (days per week). Linear mixed models were used to adjust for potential confounders and to account for each family.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analyzed 4589 visits made by 89 families of 110 preterm infants. There were 69, 33, and 24 infants in the R1, R2, and R3 groups, respectively. In a linear mixed model, duration of at least one of the parents' presence in the NICU (mean difference [95% confidence interval]) was significantly longer in the R2 group than that in the R1 group (54.9 [36.9\u201368.5] min), and also in the R3 group than that in the R2 group (28.4 [9.3\u201345.8] min). Additionally, the frequency of parental visits to the NICU per week did not change between R1 and R2, but it increased significantly between R2 and R3 (0.5 [0.1\u20130.9]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alleviating restrictive measures in NICUs may increase parental presence and visit frequency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70460","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:47:48Z","timestamp":1783939668000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of\n                    <scp>COVID<\/scp>\n                    \u201019\u2010Related Restrictions on Parental Presence and Activities in the Neonatal Intensive Care Unit"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3245-0906","authenticated-orcid":false,"given":"Ryo","family":"Itoshima","sequence":"first","affiliation":[{"name":"Division of Neonatology Nagano Children's Hospital  Azumino Japan"},{"name":"Life Science Research Center Nagano Children's Hospital  Azumino Japan"},{"name":"Department of Clinical Medicine University of Turku  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arata","family":"Oda","sequence":"additional","affiliation":[{"name":"Division of Neonatology Nagano Children's Hospital  Azumino Japan"},{"name":"Life Science Research Center Nagano Children's Hospital  Azumino Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimitsu","family":"Yanagisawa","sequence":"additional","affiliation":[{"name":"Division of Neonatology Nagano Children's Hospital  Azumino Japan"},{"name":"Life Science Research Center Nagano Children's Hospital  Azumino Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"issue":"8","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1038\/jp.2013.4","article-title":"Parental Presence and Holding in the Neonatal Intensive Care Unit and Associations With Early Neurobehavior","volume":"33","author":"Reynolds L. C.","year":"2013","journal-title":"Journal of Perinatology"},{"issue":"12","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1001\/archpedi.158.12.1153","article-title":"Visiting Less Than Every Day: A Marker for Later Behavioral Problems in Finnish Preterm Infants","volume":"158","author":"Latva R.","year":"2004","journal-title":"Archives of Pediatrics & Adolescent Medicine"},{"issue":"3","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1038\/s41372-023-01745-x","article-title":"Parent and Grandparent Neonatal Intensive Care Unit Visitation for Preterm Infants","volume":"44","author":"Harris L. M.","year":"2024","journal-title":"Journal of Perinatology"},{"issue":"1","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"e2022057092O","DOI":"10.1542\/peds.2022-057092O","article-title":"Family Involvement in the Routine Care of Hospitalized Preterm or Low Birth Weight Infants: A Systematic Review and Meta\u2010Analysis","volume":"150","author":"North K.","year":"2022","journal-title":"Pediatrics"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"102155","DOI":"10.1016\/j.eclinm.2023.102155","article-title":"New World Health Organization Recommendations for Care of Preterm or Low Birth Weight Infants: Health Policy","volume":"63","author":"Darmstadt G. L.","year":"2023","journal-title":"EClinicalMedicine"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.earlhumdev.2018.05.004","article-title":"Kangaroo Mother Care and Infant Biopsychosocial Outcomes in the First Year: A Meta\u2010Analysis","volume":"122","author":"Akbari E.","year":"2018","journal-title":"Early Human Development"},{"issue":"2","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jped.2021.06.004","article-title":"The Effectiveness of Kangaroo Mother Care in Hospitalization Period of Preterm and Low Birth Weight Infants: Systematic Review and Meta\u2010Analysis","volume":"98","author":"Narciso L. M.","year":"2022","journal-title":"Jornal de Pediatria"},{"issue":"1","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"e20152238","DOI":"10.1542\/peds.2015-2238","article-title":"Kangaroo Mother Care and Neonatal Outcomes: A Meta\u2010Analysis","volume":"137","author":"Boundy E. O.","year":"2016","journal-title":"Pediatrics"},{"issue":"4","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1111\/apa.17106","article-title":"Effects of Liberalising Visiting Policy and Staff Education on Parental Visiting Duration in the Neonatal Unit","volume":"113","author":"Schuler R.","year":"2024","journal-title":"Acta Paediatrica"},{"key":"e_1_2_12_11_1","volume-title":"National Survey on the Publicly Announced Rate of Male Employees Taking Parental Leave in 2023 (Japanese)","author":"Ministry of Health Labour and Welfare","year":"2023"},{"issue":"6","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1111\/wvn.12475","article-title":"The Development of Data Collection Tools to Measure Parent\u2013Infant Closeness and Family\u2010Centered Care in NICUs","volume":"17","author":"Axelin A.","year":"2020","journal-title":"Worldviews on Evidence\u2010Based Nursing"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.earlhumdev.2017.12.008","article-title":"Parent Participation in the Neonatal Intensive Care Unit: Predictors and Relationships to Neurobehavior and Developmental Outcomes","volume":"117","author":"Pineda R.","year":"2018","journal-title":"Early Human Development"},{"issue":"6","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1111\/apa.13798","article-title":"Parents' Presence and Parent\u2013Infant Closeness in 11 Neonatal Intensive Care Units in Six European Countries Vary Between and Within the Countries","volume":"106","author":"Raiskila S.","year":"2017","journal-title":"Acta Paediatrica"},{"key":"e_1_2_12_15_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2025"},{"issue":"43","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.21105\/joss.01686","article-title":"Welcome to the Tidyverse","volume":"4","author":"Wickham H.","year":"2019","journal-title":"Journal of Open Source Software"},{"issue":"1","key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting Linear Mixed\u2010Effects Models Using lme4","volume":"67","author":"Bates D.","year":"2015","journal-title":"Journal of Statistical Software"},{"key":"e_1_2_12_18_1","unstructured":"D.Makowski M. S.Ben\u2010Shachar I.Patil andD.L\u00fcdecke Estimation of Model\u2010Based Predictions Contrasts and Means 2025 https:\/\/github.com\/easystats\/modelbased."},{"issue":"4","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"F364","DOI":"10.1136\/archdischild-2016-312180","article-title":"Eight Principles for Patient\u2010Centred and Family\u2010Centred Care for Newborns in the Neonatal Intensive Care Unit","volume":"102","author":"Rou\u00e9 J. M.","year":"2017","journal-title":"Archives of Disease in Childhood. Fetal and Neonatal Edition"},{"issue":"4","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.aucc.2016.09.003","article-title":"Parent and Nurse Perceptions on the Quality of Family\u2010Centred Care in 11 European NICUs","volume":"29","author":"Raiskila S.","year":"2016","journal-title":"Australian Critical Care"},{"issue":"9","key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1056\/NEJM197203022860904","article-title":"Maternal Attachment. Importance of the First Post\u2010Partum Days","volume":"286","author":"Klaus M. H.","year":"1972","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.jad.2022.12.075","article-title":"The Long\u2010Term Association Between Paternal Involvement in Infant Care and Children's Psychological Well\u2010Being at Age 16\u2009Years: An Analysis of the Japanese Longitudinal Survey of Newborns in the 21st Century 2001 Cohort","volume":"324","author":"Kato T.","year":"2023","journal-title":"Journal of Affective Disorders"},{"issue":"1","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/s12884-024-06447-6","article-title":"Essential Components of an Educational Program for Implementing Skin\u2010To\u2010Skin Contact for Preterm Infants in Intensive Care Units: An Integrative Literature Review","volume":"24","author":"Denge T. T.","year":"2024","journal-title":"BMC Pregnancy and Childbirth"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70460","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70460","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70460","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:47:53Z","timestamp":1783939673000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70460"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ped.70460"],"URL":"https:\/\/doi.org\/10.1111\/ped.70460","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-02-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70460"}}