Published online September 28, 2009
PEDIATRICS Vol. 124 No. 4 October 2009, pp. 1009-1020 (doi:10.1542/peds.2008-3808)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Google Scholar
Right arrow Articles by Peters, K. L.
Right arrow Articles by Tyebkhan, J. M.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Peters, K. L.
Right arrow Articles by Tyebkhan, J. M.
Related Collections
Right arrow Developmental/Behavior
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Improvement of Short- and Long-Term Outcomes for Very Low Birth Weight Infants: Edmonton NIDCAP Trial

Kathrine Leigh Peters, PhD, RNa,b, Rhonda Jean Rosychuk, PhD, PStatc,d, Leonora Hendson, MBBCh, MSc, FRCPCc,d,e,f, Judith Jean Coté, MN, RNa,e, Catherine McPherson, BScN, RNe and Juzer Mohamed Tyebkhan, MBBS, MRCP, FRCPCc,d,e

a Faculty of Nursing
b Perinatal Clinical Research Centre
c Department of Pediatrics
d Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada
e Northern Alberta Neonatal Intensive Care Program, Stollery Children's Hospital, Edmonton, Canada
f Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital, Edmonton, Canada

OBJECTIVE: Our objective was to determine the impact of Newborn Individualized Developmental Care and Assessment Program (NIDCAP)-based care on length of stay of very low birth weight (VLBW) infants. Secondary outcome measures were days of ventilation, incidence of chronic lung disease, and 18-month neurodevelopmental outcomes.

METHODS: This cluster-randomized, controlled trial took place in a large NICU in Canada, with follow-up evaluation at 18 months of age, from September 1999 to September 2004. One hundred VLBW singleton infants and 10 VLBW twin sets were assigned randomly to NIDCAP-based or control care, and 90% participated in follow-up assessments. The intervention was NIDCAP-based care (N = 56), that is, care by NIDCAP-educated staff members and behavioral observations. The control group (N = 55) received standard NICU care. Statistical analyses were adjusted for cluster randomization. Although the intervention was not blinded, the pediatricians making the decisions to discharge the infants were not involved in the study, and the follow-up staff members were blinded with respect to group.

RESULTS: NIDCAP group infants had reduced length of stay (median: NIDCAP: 74 days; control: 84 days; P = .003) and incidence of chronic lung disease (NIDCAP: 29%; control: 49%; odds ratio: 0.42 [95% confidence interval: 0.18–0.95]; P = .035). At 18 months of adjusted age, NIDCAP group infants had less disability, specifically mental delay (NIDCAP: 10%; control: 30%; odds ratio: 0.25 [95% confidence interval: 0.08–0.82]; P = .017).

CONCLUSION: NIDCAP-based care for VLBW infants improved short- and long-term outcomes significantly.

Key Words: developmental care • Newborn Individualized Developmental Care and Assessment Program • very low birth weight infant • premature infant • neonatology • neurodevelopmental outcomes

Abbreviations: CI—confidence interval • CLD—chronic lung disease • CP—cerebral palsy • CPAP—continuous positive airway pressure • HR—hazard ratio • LOS—length of stay • MDI—Mental Developmental Index • NIDCAP—Newborn Individualized Developmental Care and Assessment Program • OR—odds ratio • RCT—randomized, controlled trial • VLBW—very low birth weight

Accepted Apr 9, 2009.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 PediatricsHome page
H. Als
NIDCAP: Testing the Effectiveness of a Relationship-Based Comprehensive Intervention
Pediatrics, October 1, 2009; 124(4): 1208 - 1210.
[Full Text] [PDF]

Home page
 PediatricsHome page
A. Ohlsson
NIDCAP: New Controversial Evidence for Its Effectiveness
Pediatrics, October 1, 2009; 124(4): 1213 - 1215.
[Full Text] [PDF]