NIDCAP improves brain function and structure in preterm infants with severe intrauterine growth restriction.
OBJECTIVE
The effect of NIDCAP (Newborn Individualized Developmental Care and Assessment Program) was examined on the neurobehavioral, electrophysiological and neurostructural development of preterm infants with severe intrauterine growth restriction (IUGR).


METHODS
A total of 30 infants, 27-33 weeks gestation, were randomized to control (C; N=17) or NIDCAP/experimental (E; N=13) care. Baseline health and demographics were assessed at intake; electroencephalography (EEG) and magnetic resonance imaging (MRI) at 35 and 42 weeks postmenstrual age; and health, growth and neurobehavior at 42 weeks and 9 months corrected age (9 months).


RESULTS
C and E infants were comparable in health and demographics at baseline. At follow-up, E infants were healthier, showed significantly improved brain development and better neurobehavior. Neurobehavior, EEG and MRI discriminated between C and E infants. Neurobehavior at 42 weeks correlated with EEG and MRI at 42 weeks and neurobehavior at 9 months.


CONCLUSIONS
NIDCAP significantly improved IUGR preterm infants' neurobehavior, electrophysiology and brain structure. Longer-term outcome assessment and larger samples are recommended.
Department of Psychiatry, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA. heidelise.als@childrens.harvard.edu
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H
Als
F H
FH
Duffy
G
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McAnulty
S C
SC
Butler
L
L
Lightbody
S
S
Kosta
N I
NI
Weisenfeld
R
R
Robertson
R B
RB
Parad
S A
SA
Ringer
J G
JG
Blickman
D
D
Zurakowski
S K
SK
Warfield
D001921:Brain / Q000254:growth & development* / Q000502:physiology; D002657:Child Development / Q000502:physiology*; D004569:Electroencephalography; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007235:Infant, Premature, Diseases / Q000503:physiopathology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male