title: Preventive care at home for very preterm infants improves infant and caregiver outcomes at 2 years.
abstract: OBJECTIVE
  The objective of this study was to determine the effects of preventive care at home on child development and primary caregiver mental health at 2 years of age.
  
  
  METHODS
  A total of 120 very preterm infants (<30 weeks) were assigned randomly to intervention (n = 61) or control (n = 59) groups. The intervention group received the preventive care program (9 home visits over the first year from a physiotherapist and a psychologist, focusing on the parent-infant relationship, the parents' mental health, and the infant's development); and the control group received standard care. At corrected age of 2 years, developmental outcomes were assessed, and primary caregivers completed the Infant-Toddler Social and Emotional Assessment. The mental health of the primary caregivers was assessed with the Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  At 2 years of age, 115 children (96%) were assessed with the Bayley Scales of Infant and Toddler Development III and 100 children (83%) with the Infant-Toddler Social and Emotional Assessment; and 91 (86%) of 106 caregivers completed the Hospital Anxiety and Depression Scale. There were no statistically significant differences in cognitive, language, or motor composite scores between the treatment groups. However, children in the intervention group were reported by their primary caregivers to exhibit less externalizing and dysregulation behaviors and increased competence, compared with control subjects. Primary caregivers in the intervention group reported less anxiety and depression.
  
  
  CONCLUSIONS
  A preventive care program for very preterm infants and their families improved behavioral outcomes for infants and reduced anxiety and depression for primary caregivers.
authors.affiliation: Murdoch Childrens Research Institute, Victoria Infant Brain Studies, Melbourne, Australia. aspittle@unimelb.edu.au
authors.forename: Alicia J
authors.initials: AJ
authors.lastname: Spittle
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Anderson
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Lee
authors.forename: Carmel
authors.initials: C
authors.lastname: Ferretti
authors.forename: Abbey
authors.initials: A
authors.lastname: Eeles
authors.forename: Jane
authors.initials: J
authors.lastname: Orton
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
authors.forename: Terrie
authors.initials: T
authors.lastname: Inder
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
mesh_terms: D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D002652:Child Behavior; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D016001:Confidence Intervals; D003266:Continuity of Patient Care; D002658:Developmental Disabilities / Q000517:prevention & control; D018479:Early Intervention, Educational / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000628:therapy; D008297:Male; D009034:Mother-Child Relations; D016017:Odds Ratio; D018570:Risk Assessment; D016896:Treatment Outcome