Published online September 28, 2009
PEDIATRICS Vol. 124 No. 4 October 2009, pp. 1021-1030 (doi:10.1542/peds.2008-1881)
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ARTICLE

Effects of Individualized Developmental Care in a Randomized Trial of Preterm Infants <32 Weeks

Celeste M. Maguire, PhDa, Frans J. Walther, MD, PhDa, Arwen J. Sprij, MDb, Saskia Le Cessie, PhDc, Jan M. Wit, MD, PhDa, Sylvia Veen, MD, PhDa for the Leiden Developmental Care Project

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

OBJECTIVE: The goal was to investigate the effects of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on days of respiratory support and intensive care, growth, and neuromotor development at term age for infants born at <32 weeks.

METHODS: Infants were assigned randomly, within 48 hours after birth, to a NIDCAP group or basic developmental care (control) group. The NIDCAP intervention consisted of weekly formal behavioral observations of the infants and caregiving recommendations and support for staff members and parents, as well as incubator covers and positioning aids. The control group infants were given basic developmental care, which consisted of only incubator covers and positioning aids. Outcome measures were respiratory support, intensive care, and weight of <1000 g. Growth parameters were measured weekly or biweekly and at term age. Neuromotor development was assessed at term age.

RESULTS: A total of 164 infants met the inclusion criteria (NIDCAP: N = 81; control: N = 83). In-hospital mortality rates were 8 (9.9%) of 81 infants in the NIDCAP group and 3 (3.6%) of 83 infants in the control group. No differences in mean days of respiratory support (NIDCAP: 13.9 days; control: 16.3 days) or mean days of intensive care (NIDCAP: 15.2 days; control: 17.0 days) were found. Short-term growth and neuromotor development at term age showed no differences, even with correction for the duration of the intervention.

CONCLUSIONS: NIDCAP developmental care had no effect on respiratory support, days of intensive care, growth, or neuromotor development at term age.

Key Words: preterm infants • developmental care • Newborn Individualized Developmental Care and Assessment Program • growth • respiratory support • intensive care • neurodevelopment

Abbreviations: NIDCAP—Newborn Individualized Developmental Care and Assessment Program • RCT—randomized, controlled trial • PDA—patent ductus arteriosus • CPAP—continuous positive airway pressure • GA—gestational age

Accepted Apr 9, 2009.


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