Individualized developmental care for a large sample of very preterm infants: health, neurobehaviour and neurophysiology

• Published in: Acta Paediatrica Vol. 98; no. 12; pp. 1920 - 1926
• Main Authors: McAnulty, G, Duffy, FH, Butler, S, Parad, R, Ringer, S, Zurakowski, D, Als, H
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-12-2009; Blackwell
• Subjects: Analysis of Variance; Behaviour; Biological and medical sciences; Child Development - physiology; Diseases of mother, fetus and pregnancy; EEG spectral coherence; Female; General aspects; Gestational Age; Gynecology. Andrology. Obstetrics; Health Status; Humans; Infant Care - methods; Infant, Newborn; Infant, Premature - growth & development; Infant, Very Low Birth Weight - growth & development; Intensive Care, Neonatal - methods; Male; Medical sciences; Miscellaneous; Neurodevelopment; Neurophysiology; Neuropsychology; NIDCAP; Patient Care Planning; Pregnancy. Fetus. Placenta; Prematurity; Program Evaluation; Public health. Hygiene; Public health. Hygiene-occupational medicine; Treatment Outcome; Human; Premature; Pediatrics; Pregnancy disorders; Behaviour; Sample; EEG spectral coherence; Electrophysiology; Premature delivery; Infant; Electroencephalography; Care; Neurophysiology; Very low birthweight; Electrodiagnosis; Newborn diseases; Prematurity; Coherence; NIDCAP; Development; Neurodevelopment; Behavior; Public health
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2009.01492.x

Aim:  To assess medical and neurodevelopmental effects of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) for a large sample of very early‐born infants.
Methods:  One hundred and seven singleton inborn preterm infants, <29 weeks gestational age (GA), <1250 g birth weight, enrolled in three consecutive phases, were randomized within phase to NIDCAP (treatment, E) or standard care (C). Treatment extended from admission to the Newborn Intensive Care Unit to 2 weeks corrected age (wCA). Outcome included medical, neurobehavioural and neurophysiological status at 2 wCA, and growth and neurobehavioural status at 9 months (m) CA.
Results:  The C‐ and E‐group within each of the three consecutive phases and across the three phases were comparable in terms of all background measures; they therefore were treated as one sample. The results indicated for the E‐group significant reduction in major medical morbidities of prematurity as well as significantly improved neurodevelopmental (behaviour and electrophysiology) functioning at 2 wCA; significantly better neurobehavioural functioning was also found at 9 mCA.
Conclusion:  The NIDCAP is an effective treatment for very early‐born infants. It reduces health morbidities and enhances neurodevelopment, functional competence and life quality for preterm infants at 2 w and 9 mCA.