Development and growth in very preterm infants in relation to NIDCAP in a Dutch NICU: two years of follow-up.
OBJECTIVE
To study development and growth in relation to newborn individualized developmental and assessment program (NIDCAP) for infants born with a gestational age of less than 30 weeks.


METHODS
Developmental outcome of surviving infants, 25 in the NIDCAP group and 24 in the conventional care group, in a prospective phase-lag cohort study performed in a Dutch level III neonatal intensive care unit (NICU) was compared. Main outcome measure was the Bayley scales of infant development-II (BSID-II) at 24 months corrected age. Secondary outcomes were neurobehavioral and developmental outcome and growth at term, 6, 12 and 24 months.


RESULTS
Accounting for group differences and known outcome predictors no significant differences were seen between both care groups in BSID-II at 24 months. At term age NIDCAP infants scored statistically significant lower on neurobehavioral competence; motor system (median [IQR] 4.8 [2.9-5.0] vs. 5.2 [4.3-5.7], p = 0.021) and autonomic stability (median [IQR] 5.7 [4.8-6.7] vs. 7.0 [6.0-7.7], p = 0.001). No differences were seen in other developmental outcomes. After adjustment for background differences, growth parameters were comparable between groups during the first 24 months of life.


CONCLUSIONS
At present, the strength of conclusions to be drawn about the effect of NIDCAP on developmental outcome or growth at 24 months of age is restricted. Further studies employing standardized assessment approaches including choice of measurement instruments and time points are needed.
Wielenga
J M
JM
Department of Neonatology, Academic Medical Center/Emma Children's Hospital, Amsterdam, The Netherlands. j.wielenga@amc.uva.nl
Smit
B J
BJ
Merkus
M P
MP
Wolf
M J
MJ
van Sonderen
L
L
Kok
J H
JH
D002662:Child Health Services; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007363:Intensive Care Units, Neonatal; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D013997:Time Factors