Published online March 30, 2009
PEDIATRICS Vol. 123 No. 4 April 2009, pp. 1081-1087 (doi:10.1542/peds.2008-1950)
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ARTICLE

Follow-up Outcomes at 1 and 2 Years of Infants Born Less Than 32 Weeks After Newborn Individualized Developmental Care and Assessment Program

Celeste M. Maguire, PhDa, Frans J. Walther, MD, PhDa, Paul H. T. van Zwieten, MDb, Saskia Le Cessie, PhDc, Jan M. Wit, MD, PhDa, Sylvia Veen, MD, PhD 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, Hague, Netherlands

OBJECTIVE. This was a randomized, controlled trial to investigate the effect of Newborn Individualized Developmental Care and Assessment Program on growth, cognitive, psychomotor, and neuromotor development at 1 and 2 years in infants born at <32 weeks’ gestational age.

METHODS. Infants were randomly assigned within 48 hours of birth to the newborn individualized developmental care and assessment program group (intervention) or basic developmental care group (control group [ie, incubator covers and nests]). At 1 and 2 years’ corrected age, growth was measured and standardized neurologic examinations were administered. Mental and psychomotor development was assessed by using the Dutch version of the Bayley Scales of Infant Development II. Neurologic outcome, Psychomotor Developmental Index, and Mental Developmental Index scores were combined a total outcome measure.

RESULTS. One hundred sixty-eight infants were recruited (intervention: 84; control: 84). Four infants (newborn intervention: 3; control: 1) were excluded because they were admitted less than or died within the first 5 days, leaving a total of 164 infants who met inclusion criteria. In-hospital mortality was 8 of 81 in the intervention group and 3 of 83 in the control group. At 1 year of age 148 children (intervention: 70; control: 78) and at 2 years of age 146 children (intervention: 68; control: 78) were assessed. There was no significant difference in growth at 1 and 2 years of age. There was no significant difference found in neurologic outcomes or mental and psychomotor development at 1 and 2 years of age. When neurologic outcome, Mental Developmental Index and Psychomotor Developmental Index scores were combined, there still remained no significant difference.

CONCLUSIONS. Newborn individualized developmental care and assessment program developmental care showed no effect on growth or neurologic, mental, or psychomotor development at 1 and 2 years of age in infants born at <32 weeks. Duration of the intervention was not associated with neurologic and developmental outcome.

Key Words: preterm infants • developmental care • NIDCAP • growth • neurodevelopment • Bayley Scales of Infant Development • follow-up

Abbreviations: DC—developmental care • NIDCAP—newborn individualized developmental care and assessment program • RCT—randomized, controlled trial • CA—corrected age • GA—gestational age • SGA—small for gestational age • CRIB—Clinical Risk Index for Babies • DA—definitely abnormal • MA—mildly abnormal • BSID-II—Bayley Scales of Infant Development II • MDI—Mental Developmental Index • PDI—Psychomotor Developmental Index • PDA—patent ductus arteriosus • SDS—SD score

Accepted Aug 13, 2008.


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