A Randomized, Controlled Trial of the Effectiveness of an Early-Intervention Program in Reducing Parenting Stress After Preterm Birth

Kaaresen, Per Ivar; Rønning, John A.; Ulvund, Stein Erik; Dahl, Lauritz Bredrup

doi:10.1542/peds.2005-1491

Cited by 250 publications

(239 citation statements)

References 37 publications

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“…Premature birth and the newborn intensive care environment are stressful to both mother and infant and are associated with long-term consequences to the parent-child relationship. 22,29 Massage, 16 skin-to-skin contact (kangaroo care) 21 and other intervention strategies 22 have been used in the newborn intensive care environment to decrease stress and improve parent-child interactions. We noted a high level of compliance by mothers who performed the physical activity intervention for their infants.…”

Section: Discussionmentioning

confidence: 99%

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

et al. 2008

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Objective: To determine if physical activity delivered by an infant's mother would be as effective in promoting bone mineral acquisition in preterm very low birth weight (VLBW) infants as the same intervention administered by a trained therapist.Patients and methods: Preterm VLBW infants were randomized to receive daily physical activity administered by the infant's mother (MOM, n ¼ 11) or a trained therapist (OT, n ¼ 11), or control (n ¼ 11). Physical activity consisted of range of motion movements against passive resistance to all extremities for 5 to 10 min daily. All infants were fed mother's milk with fortification to 24 kcal oz À1 . Dual energy x-ray of the forearm bone area (BA, cm 2 ), mineral content (BMC, g), and density (BMD, g/cm 2 ) and measurement of bone formation (bone-specific alkaline phosphatase, BAP) and resorption (urine pyridinium crosslinks of collagen, Pyd) were obtained at study entry and at 2.0 kg of body weight.Result: Forearm BA and BMC gains were greater in MOM and OT infants compared to the control infants despite similar postnatal growth rate and nutrient intake. Serum BAP levels decreased in controls but remained unchanged in MOM and OT infants. Urine Pyd levels were similar at baseline to 2.0 kg for all groups. These findings suggest greater bone growth and mineral acquisition in MOM and OT infants than control infants. Conclusion:This study demonstrates that a physical activity program administered by the infant's own mother is as equally effective as therapist-administered physical activity in promoting greater bone growth and mineral acquisition in preterm VLBW infants.

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Section: Discussionmentioning

confidence: 99%

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

et al. 2008

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“…27 Parents were taught to wait for the infant's responses and to modify the support according to the infant's reactions to handling to ensure that the infants were actively participating during the intervention. The parents chose the time of day for performing the two 10-minute interventions based on their infants' availability to fully interact.…”

Section: Interventionmentioning

confidence: 99%

Early Parent-Administered Physical Therapy for Preterm Infants: A Randomized Controlled Trial

et al. 2016

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OBJECTIVE: To investigate the short-term effect of parent-administered physical therapy in the preterm period on motor performance in medically stable infants. METHODS:This study was a pragmatic, multicenter, randomized controlled trial including 153 infants born at gestational age ≤32 weeks and randomized to an intervention (n = 74) or a control (n = 79) group. The intervention promoted postural control, head control, and midline orientation. Parents, supervised by a physical therapist, conducted the intervention 10 minutes twice a day for 3 weeks from 34 to 36 weeks' postmenstrual age (PMA). The control group received usual care. The Test of Infant Motor Performance Screening Items was used at baseline and the Test of Infant Motor Performance postintervention (week 37 PMA). Linear mixed models were used to assess change in motor performance between groups from 34 to 37 weeks' PMA by using z scores. Effect size was measured by using Cohen's d. RESULTS:The mean baseline z score was 0.06 (95% confidence interval, -0.48 to 0.60). After the intervention, there was a significant group difference, indicating a change in motor performance from week 34 to 37 PMA favoring the intervention group. The estimated difference in z scores was 0.42 (95% confidence interval, 0.13 to 0.72; P = .005), and the effect size was 0.40.CONCLUSIONS: Parent-administered physical therapy conducted before term-equivalent age improved motor performance at 37 weeks' PMA more than conventional care. All infants will be followed up until 2 years' corrected age to evaluate the long-term effects of this brief intervention. Mrs Ustad participated in planning the study, baseline and postintervention assessments, statistical analyses, and drafting of the manuscript; Dr Evensen was involved in supervision of statistical analyses and preparation of the manuscript; Drs Campbell and Girolami participated in planning the study, in preparation of the manuscript, and in proofreading; Dr Helbostad supervised the statistical analyses and preparation of the manuscript; Drs Kaaresen and Jørgensen participated in planning the study and in preparation of the manuscript; and Dr Øberg was responsible for design and planning the study and participated in postintervention assessments from video recordings, statistical analyses, and preparation of the manuscript. All authors approved the fi nal manuscript as submitted and agree to be accountable for all aspects of the work. WHAT'S KNOWN ON THIS SUBJECT: Studies on early intervention to improve motor function in preterm infants have failed to show large effects. Interventions involving parents seem to be more effective than when therapists conduct the intervention. WHAT THIS STUDY ADDS:Three weeks of parentadministered physical therapy implemented before term-equivalent age in very preterm infants improved short-term motor performance more than in the control group. The intervention was feasible and well tolerated by the infants.by guest on May 10, 2018 http://pediatrics.aappublications.org/ Downloaded from U...

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“…Most of the studies focus on maternal stress in general; there is even less information about a father's long-term adaptation (9,17,18). However, the family should be evaluated as a whole including both parents.…”

Section: Introductionmentioning

confidence: 99%

The Anxiety Levels of the Parents of Premature Infants and Related Factors

Arslan¹

2017

jpr

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A Randomized, Controlled Trial of the Effectiveness of an Early-Intervention Program in Reducing Parenting Stress After Preterm Birth

Abstract: This early-intervention program reduces parenting stress among both mothers and fathers of preterm infants to a level comparable to their term peers. We are now studying whether this will result in long-term beneficial effects.

Cited by 250 publications

References 37 publications

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

Early Parent-Administered Physical Therapy for Preterm Infants: A Randomized Controlled Trial

The Anxiety Levels of the Parents of Premature Infants and Related Factors

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