Individualized developmental care for a large sample of very preterm infants: health, neurobehaviour and neurophysiology.
OBJECTIVE
To assess medical and neurodevelopmental effects of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) for a large sample of very early-born infants.


METHODS
One hundred and seven singleton inborn preterm infants, <29 weeks gestational age (GA), <1250 g birth weight, enrolled in three consecutive phases, were randomized within phase to NIDCAP (treatment, E) or standard care (C). Treatment extended from admission to the Newborn Intensive Care Unit to 2 weeks corrected age (wCA). Outcome included medical, neurobehavioural and neurophysiological status at 2 wCA, and growth and neurobehavioural status at 9 months (m) CA.


RESULTS
The C- and E-group within each of the three consecutive phases and across the three phases were comparable in terms of all background measures; they therefore were treated as one sample. The results indicated for the E-group significant reduction in major medical morbidities of prematurity as well as significantly improved neurodevelopmental (behaviour and electrophysiology) functioning at 2 wCA; significantly better neurobehavioural functioning was also found at 9 mCA.


CONCLUSIONS
The NIDCAP is an effective treatment for very early-born infants. It reduces health morbidities and enhances neurodevelopment, functional competence and life quality for preterm infants at 2 w and 9 mCA.
McAnulty
G
G
Department of Psychiatry (Psychology), Children's Hospital Boston and Harvard Medical School, Boston, MA, USA.
Duffy
F H
FH
Butler
S
S
Parad
R
R
Ringer
S
S
Zurakowski
D
D
Als
H
H
D000704:Analysis of Variance; D002657:Child Development / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006304:Health Status; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D009482:Neurophysiology; D009484:Neuropsychology; D010347:Patient Care Planning; D015397:Program Evaluation; D016896:Treatment Outcome