Does quality of developmental care in NICUs affect health-related quality of life in 5-y-old children born preterm?

Montirosso, Rosario; Giusti, Lorenzo; Prete, Alberto Del; Zanini, Rinaldo; Bellù, Roberto; Borgatti, Renato

doi:10.1038/pr.2016.158

Cited by 14 publications

(21 citation statements)

References 24 publications

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“…Preterm birth has a long‐term impact on health‐related quality of life, especially in the preschool years . In our study, at 60 months, children from NICUs with high‐quality infant‐centered care scored higher in this area than children from NICUs with low‐quality infant‐centered care, even after controlling for families' socioeconomic status, parents' distress, and children's development (i.e., social, self‐help, motor, language, and letter and number skills; ). Although it is unclear which process might be involved (e.g., parents might learn early how to scaffold infants' self‐regulatory capacity and buffer infants from stress; ), this NEO‐ACQUA finding suggests that more frequent NC in the neonatal period can promote quality of life up to age 5.…”

Section: Insights From the Neo‐acqua Studymentioning

confidence: 46%

Promoting Neuroprotective Care in Neonatal Intensive Care Units and Preterm Infant Development: Insights From the Neonatal Adequate Care for Quality of Life Study

Montirosso

Tronick²,

Borgatti

2016

Child Dev Perspectives

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During their stay in a neonatal intensive care unit (NICU), preterm infants are exposed to adverse stressful experiences that deplete their resources and often result in problematic functioning and developmental outcomes. The impact of specific developmental care practices (e.g., kangaroo care) on preterm infants has been researched extensively. Moreover, the dissemination of knowledge about developmental care has facilitated broader neuroprotective care (NC) that combines different kinds of developmental care practices in different NICUs. However, little is known about how variation in NC affects infants and their long‐term developmental outcomes. Using the findings from the Neonatal Adequate Care for Quality of Life project, in this article, we discuss how variation in the NC incorporated by NICUs into standard care affects short‐ and long‐term outcomes in children born preterm.

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Section: Insights From the Neo‐acqua Studymentioning

confidence: 46%

Promoting Neuroprotective Care in Neonatal Intensive Care Units and Preterm Infant Development: Insights From the Neonatal Adequate Care for Quality of Life Study

Montirosso

Tronick²,

Borgatti

2016

Child Dev Perspectives

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“…At 9 months postpartum, VLBW infants showed a higher quotient compared to the FT group and this result emerged only in the case of non-anxious mothers. This somehow unexpected result may possibly be explained considering the fact that the VLBW group represents a low risk sample and it could have taken advantage of the supportive interventions realized in NICU and during the follow-up programs (Biasini et al, 2015;Montirosso et al, 2016;Neri et al, 2017), aimed at promoting both infants' communicative skills and parents' ability to support infant vocalizations. However, when maternal anxiety is present in the VLBW group, this may mediate the efficacy of interventions in improving Hearing and Language skills.…”

Section: Discussionmentioning

confidence: 99%

Developmental Dimensions in Preterm Infants During the 1st Year of Life: The Influence of Severity of Prematurity and Maternal Generalized Anxiety

et al. 2020

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Background: The literature has recognized premature birth as a risk factor for infant development and maternal anxiety. This study investigated the impact of the severity of birth weight, as well as of maternal anxiety at 3 months of infants' corrected age, on infants' outcomes during the 1st year postpartum. Moreover, it described the longitudinal trajectories of developmental outcomes, additionally exploring the impact of anxiety. Methods: The study compared 147 mothers and their 147 newborns, differentiated in 25 Extremely Low Birth Weight (ELBW), 41 Very Low Birth Weight (VLBW), and 81 Full-Term (FT) infants. At 3, 9, and 12 months (corrected age in the case of preterm infants) the level of infants' development was investigated according to the 5 quotients (Locomotor, Personal and Social, Hearing and Language, Eye-hand Coordination and Performance) of the Griffiths Mental Development Scales (GMDS-R). During the assessment of 3 months, mothers fulfilled Penn State Worry Questionnaire (PSWQ) to evaluate the presence of generalized anxiety. Results: Among the 5 GMDS-R quotients, significant effect of severity of birth weight emerged only for Performance quotient: preterm infants (ELBW at 3 months; VLBW at 12 months) showed lower scores than FT ones. Moreover, this quotient decreased from 3 to 9 and to 12 months for VLBW and FT infants, while it was stable for ELBW ones. A significant interaction between severity of birth weight and maternal anxiety emerged for Hearing and Language and Locomotor quotients. In the first case, scores for ELBW infants, independently from maternal anxiety, decreased from 9 to 12 months. The same results emerged for VLBW infants, in the case of non-anxious mothers. Regarding Locomotor quotient, mean scores decreased from 3 to 9 and to 12 months for all groups in the case of non-anxious mothers. Conversely, when mothers were anxious, this decrease emerged only for VLBW infants. Lastly, ELBW, VLBW and FT showed difference in the growth and slope of the trajectories of different quotients.

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“…Infant- and family-centered developmental care programs aim to adapt the sensory environment of vulnerable newborns to their sensory abilities and expectations, and to integrate parents as the primary caregivers so they can better support infant well-being and neurodevelopment, and the bonding process. Infant pain management is an important component of infant- and family-centered developmental care, and has documented short- and long-term benefits (Montirosso et al, 2012b, 2016a,b). This holistic approach can support infant pain management through an architectural NICU design that supports parental presence, close observation of the infant, high involvement of parents as primary caregivers, and coordinated use of non-pharmacological methods for pain relief.…”

Section: Role Of Oxt In Early Contact and Painful Proceduresmentioning

confidence: 99%

Pain, Parental Involvement, and Oxytocin in the Neonatal Intensive Care Unit

et al. 2019

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Preterm infants (PTI) typically experience many painful and stressful procedures or events during their first weeks of life in a neonatal intensive care unit, and these can profoundly impact subsequent brain development and function. Several protective interventions during this sensitive period stimulate the oxytocin system, reduce pain and stress, and improve brain development. This review provides an overview of the environmental risk factors experienced by PTI during hospitalization, with a focus on the effects of pain, and early maternal separation. We also describe the long-term adverse effects of the simultaneous experiences of pain and maternal separation, and the potential beneficial effects of maternal vocalizations, parental contact, and several related processes, which appear to be mediated by the oxytocin system.

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Does quality of developmental care in NICUs affect health-related quality of life in 5-y-old children born preterm?

Abstract: Findings suggest that higher quality of DC in NICU related to ICC might mitigate long-term negative quality of life outcomes.

Cited by 14 publications

References 24 publications

Promoting Neuroprotective Care in Neonatal Intensive Care Units and Preterm Infant Development: Insights From the Neonatal Adequate Care for Quality of Life Study

Promoting Neuroprotective Care in Neonatal Intensive Care Units and Preterm Infant Development: Insights From the Neonatal Adequate Care for Quality of Life Study

Developmental Dimensions in Preterm Infants During the 1st Year of Life: The Influence of Severity of Prematurity and Maternal Generalized Anxiety

Pain, Parental Involvement, and Oxytocin in the Neonatal Intensive Care Unit

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