Published online February 1, 2008
PEDIATRICS Vol. 121 No. 2 February 2008, pp. e239-e245 (doi:10.1542/peds.2007-1189)

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ARTICLE

Effects of Basic Developmental Care on Neonatal Morbidity, Neuromotor Development, and Growth at Term Age of Infants Who Were Born at <32 Weeks

Celeste M. Maguire, MS^a, Sylvia Veen, MD, PhD^a, Arwen J. Sprij, MD^b, Saskia Le Cessie, PhD^c, Jan M. Wit, MD, PhD^a, Frans J. Walther, MD, PhD^a on behalf of the Leiden Developmental Care Project

^a Subdivision of Neonatology, Department of Pediatrics
^c Department of Medical Statistics, Leiden University Medical Center, Leiden, Netherlands
^b Subdivision of Neonatology, Department of Pediatrics, Haga Hospital, Juliana Children's Hospital, The Hague, Netherlands

OBJECTIVE. The goal of this study was to investigate the effect of basic elements of developmental care (incubator covers and positioning aids) on days of respiratory support and intensive care, growth, and neuromotor development at term age in infants who were born at <32 weeks’ gestation.

METHODS. Infants were randomly assigned within 48 hours of birth to the developmental care group or the standard care control group (no covers or nests). The intervention continued until the infant either was transferred to a regional hospital or was discharged from the hospital. Length, weight, and head circumference were measured (bi)weekly and at term age. Neuromotor development was defined as definitely abnormal (presence of a neonatal neurologic syndrome, such as apathy or hyperexcitability, hypotonia or hypertonia, hyporeflexia or hyperreflexia, hypokinesia or hyperkinesia, or a hemisyndrome), mildly abnormal (presence of only part of such a syndrome), or normal.

RESULTS. A total of 192 infants were included (developmental care: 98; control: 94). Thirteen infants (developmental care: 7; control: 6) were excluded according to protocol (admitted for less than or died within the first 5 days: n = 12; taken out at parents’ request: n = 1), which left a total of 179 infants who met inclusion criteria. In-hospital mortality was 12 (13.2%) of 91 in the developmental care group and 8 (9.1%) of 88 in the control group. There was no significant difference in the number of days of respiratory support, number of intensive care days, short-term growth, or neuromotor developmental outcome at term age between the developmental care and control groups. Duration of the intervention, whether only during the intensive care period or until hospital discharge, had no significant effect on outcome.

CONCLUSIONS. Providing basic developmental care in the NICU had no effect on short-term physical and neurologic outcomes in infants who were born at <32 weeks’ gestation.

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Key Words: preterm infants • developmental care • NIDCAP • growth • respiratory support • intensive care • neurodevelopment

Abbreviations: DC—developmental care • NIDCAP—Newborn Individualized Developmental Care and Assessment Program • RCT—randomized, controlled trial • CPAP—continuous positive airway pressure • IVH—intraventricular hemorrhage

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Accepted Jun 18, 2007.

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				C M Maguire, F J Walther, P H T van Zwieten, S Le Cessie, J M Wit, S Veen, and On behalf of the Leiden Developmental Care Project No change in developmental outcome with incubator covers and nesting for very preterm infants in a randomised controlled trial Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2009; 94(2): F92 - F97. [Abstract] [Full Text] [PDF]