Early developmental intervention programs post hospital discharge to prevent motor and cognitive impairments in preterm infants

Spittle, Alicia J; Orton, Jane; Doyle, Lex W.; Boyd, Roslyn N.

doi:10.1002/14651858.cd005495.pub2

Cited by 198 publications

(161 citation statements)

References 80 publications

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“…21,24 A recent review assessed post-discharge early developmental intervention for preterm infants. 25 However, this review did not focus on interventions involving parents. This review aims to determine whether early interventions aimed at either teaching parenting skills, and/or involving parents in the hospital care of the preterm, improve either short-term and school-age neurodevelopmental outcomes of premature infants.…”

Section: Introductionmentioning

confidence: 99%

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

et al. 2009

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Objective: To determine in a systematic review, whether interventions for infant development that involve parents, improve neurodevelopment at 12 months corrected age or older.Study Design: Randomized trials were identified where an infant intervention was aimed to improve development and involved parents of preterms; and long-term neurodevelopment using standardized tests at 12 months (or longer) was reported.Result: Identified studies (n ¼ 25) used a variety of interventions including parent education, infant stimulation, home visits or individualized developmental care. Meta-analysis at 12 months (N ¼ 2198 infants) found significantly higher mental (N ¼ 2198) and physical (N ¼ 1319) performance scores favoring the intervention group. At 24 months, the mental (N ¼ 1490) performance scores were improved, but physical (N ¼ 1025) performance scores were not statistically significant. The improvement in neurodevelopmental outcome was not sustained at 36 months (N ¼ 961) and 5 years (N ¼ 1017). Conclusion:Positive clinically meaningful effects (>5 points) are seen to an age of 36 months, but are no longer present at 5 years.

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Section: Introductionmentioning

confidence: 99%

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

et al. 2009

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“…However, data from developed countries indicate that early intervention is critical to improved motor and cognitive impairments and such interventions are currently unavailable in Zambia. 29 All infants who presented for follow-up were included in the analyses; however, the characteristics of the infants who failed to keep the appointment are not known. Although previous studies in developed countries have found a bias in the outcomes of infants who present for long-term follow-up, [30][31][32] it is unclear if this is true in developing countries.…”

Section: Discussionmentioning

confidence: 99%

296 Birth Asphyxia Survivors in a Developing Country.

et al. 2006

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Objective-Determine the baseline incidence of birth asphyxia in neonatal intensive care unit (NICU) survivors in a developing country and the early neurodevelopmental outcomes of such infants.Study Design-This cross-sectional, prospective study collected diagnostic and examination findings on all infants seen in the University of Zambia NICU follow-up clinic over a 4-week period.Result-Of the 182 infants, 42 (23%) had a clinical diagnosis of birth asphyxia. Of 42 infants with birth asphyxia, 13 (31%) had an abnormal neurologic examination during the clinic visit; in contrast, 13 of 141 infants without birth asphyxia (9%) had an abnormal examination (odds ratio 4.4, 95% confidence interval: 1.8, 10.4).Conclusion-Birth asphyxia survivors account for almost a quarter of NICU survivors in a developing country and half of those with an abnormal neurologic examination. Studies are necessary to determine the percent of birth asphyxia survivors who have permanent motor and cognitive disabilities.

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“…From the systematic review by Spittle et al, 9 randomized controlled trials were selected that were preventive and family centred in nature -with at least part of the intervention programme in the home after discharge from the NICU -which were carried out in non-selected groups of very preterm infants and aimed to at least improve cognitive development at age two. By subsequently searching related papers to the selected trials in PubMed, later publications of the same trial were found as well as one additional randomized trial.…”

Section: Methodsmentioning

confidence: 99%

Rethinking preventive post‐discharge intervention programmes for very preterm infants and their parents

Wassenaer-Leemhuis

Jeukens-Visser

Hus

et al. 2016

Develop Med Child Neuro

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Post‐discharge preventive intervention programmes with involvement of the parent may support the resilience and developmental outcomes of infants born very preterm. Randomized controlled trials of home‐based family‐centred intervention programmes in very preterm infants that aimed to improve cognitive outcome, at least at age two, were selected and updated on the basis of a recent systematic review to compare their content and effect over time to form the basis of a narrative review. Six programmes were included in this narrative review. Four of the six programmes led to improved child cognitive and/or motor development. Two programmes, which focused primarily on responsive parenting and development, demonstrated improved cognitive outcome up till 5 years after completion of the programme. The programmes that also focused on maternal anxiety remediation led to improved maternal mental well‐being, along with improved child behaviour, in one study – even at 3 years after completion of the programme. The magnitude of the effects was modest. Family‐centred preventive intervention programmes that aim at improvement of child development should be continued after discharge home to improve the preterm child's resilience. Programmes may be most effective when they support the evolvement of a responsive parent–infant relationship over time, as well as the parent's well‐being.

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Early developmental intervention programs post hospital discharge to prevent motor and cognitive impairments in preterm infants

Abstract: Early developmental intervention programs post hospital discharge to prevent motor and cognitive impairments in preterm infants (Review)

Cited by 198 publications

References 80 publications

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

296 Birth Asphyxia Survivors in a Developing Country.

Rethinking preventive post‐discharge intervention programmes for very preterm infants and their parents

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