Effects of a Home-Based Family-Centred Early Habilitation Program on Neurobehavioural Outcomes of Very Preterm Born Infants: A Retrospective Cohort Study

Abstract

Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years' corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects) or to the control group (62 subjects) depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months' corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and behavioural outcomes. In addition, males had significantly lower scores than females either before or after treatment. However, the treatment was effective in both genders to the same extent. In conclusion, a timely updated environment suitable to the infant's developmental needs could provide the best substrate where the parent-infant relationship can be practised with the ultimate goal of achieving further developmental steps.

Effect of Parenting Training on Neurobehavioral Development of Infants

“…As a result, the early stage of infants is significant in brain development. The relationship between experiences and CNS plasticity two-way, which means the brain can produce adaptive behavioral changes after external stimulus [11]. By providing positive interventions, the potential of the brain can be activated.…”

“…Family-centered care is a philosophy of care that emphasizes the integrity of the family and individualizing care [18]. A retrospective cohort study focused on the environmental enrichment, parent-guided environmental interaction, and infant development assessed the effect of a home-based family-centered early developmental habilitation program, finding that both cognitive and behavioral outcomes were improved [11].…”

Profile of at-risk newborns attended by nurses in outpatient follow-up clinic: a retrospective cohort study

“…Regarding the data on GA and birth weight present in Table 1, this study found that the lower the gestational age and the birth weight, the more frequent and the greater the follow-up visits are. Some researches show this need for more frequent follow-up when they affirm that low birth weight and prematurity are related to an increase in morbidity and mortality, chronic conditions and readmissions 2 - 3 , 9 , 19 , 27 - 31 , as well as to the greater risk of growth deficit 3 , 21 , developmental delays and cognitive and behavioral problems 3 , 7 , 31 - 32 . In addition, growth must be closely monitored in the first year of life of patients with this profile, thus ensuring optimal brain nutrition and reducing risks of neurodevelopmental delays 19 , 33 .…”

“…Most of these diagnoses are found in premature infants born with less than 1,500g, neuropathic and those with longer length of stay 2 - 3 , 19 , and in some studies, they are also present in chronic infants coming from the NICU 27 and in those who most needed readmissions 9 , 11 , 29 . Neonatal conditions, such as prematurity, asphyxia, infections and hyperbilirubinemia, were associated with sequelae and compromised survival in a retrospective Italian cohort performed with 123 subjects 7 . Anemia must be monitored and treated frequently because it can lead to low weight gain and changes in development 19 , 33 .…”

Estratégias de intervenção precoce em recém-nascidos prematuros na Unidade de Terapia Intensiva Neonatal: uma revisão de literatura

“…A intervenção precoce consiste no conjunto de ações que oferecem à criança experiências sensóriomotoras necessárias desde o nascimento, para potencializar um desenvolvimento neuropsicomotor adequado, através de uma avaliação criteriosa e assistência fisioterapêutica personalizada (FORMIGA et al, 2010). É necessário aproveitar a janela de tempo mais favorável para a plasticidade cerebral, e estabelecer uma intervenção protetora e/ou restauradora o mais precocemente possível (POGGIOLI et al, 2016;CAMARGO et al, 2017). O objetivo desse estudo é realizar uma revisão bibliográfica para identificar as principais estratégias fisioterapêuticas de intervenção precoce nos recém-nascidos prematuros em unidade de terapia intensiva neonatal.…”