Principles, Practices and Outcomes of Trauma-Informed Care in NICU: A Systematic Review

Aim: This review compiles and evaluates existing research on the integration of trauma-informed care (TIC) within Neonatal Intensive Care Units (NICUs). It aims to understand how TIC practices influence infants, families, and healthcare staff, and to assess which interventions demonstrate measurable benefits in neonatal settings. Method: Searches were conducted in PubMed, Google Scholar, and related scholarly databases for literature published between 2015 and 2025. Studies were included if they addressed TIC principles, implementation strategies, or outcomes in NICU contexts. Findings were synthesized following PRISMA guidelines. Results: Fourteen eligible studies were analysed. The collective evidence shows that TIC enhances staff knowledge and communication, strengthens parental involvement, and decreases stress responses in both caregivers and infants. However, implementation was limited by variable training quality, resource restrictions, and differences in staff understanding of TIC concepts. Conclusion: TIC shows strong potential to enhance developmental, emotional, and relational outcomes within NICUs. Consistent staff education, practical toolkits, and environmental strategies are essential for successful adoption. Tailored, culturally responsive approaches are particularly important in diverse or resource-limited healthcare settings. Key words: Trauma-informed care, NICU, infant stress, family-centered care, neonatal trauma