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American Academy of Pediatrics
Article

A Randomized, Controlled Trial to Evaluate the Effects of the Newborn Individualized Developmental Care and Assessment Program in a Swedish Setting

Björn Westrup, Agneta Kleberg, Kristina von Eichwald, Karin Stjernqvist and Hugo Lagercrantz
Pediatrics January 2000, 105 (1) 66-72; DOI: https://doi.org/10.1542/peds.105.1.66
Björn Westrup
From the *Department of Clinical Science, Pediatrics, Umeå University, Umeå, Sweden;
‡Neonatal Programme, Department of Woman and Child Health, Astrid Lindgren Children's Hospital, Karolinska Institute, Stockholm, Sweden; and the
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Agneta Kleberg
‡Neonatal Programme, Department of Woman and Child Health, Astrid Lindgren Children's Hospital, Karolinska Institute, Stockholm, Sweden; and the
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Kristina von Eichwald
‡Neonatal Programme, Department of Woman and Child Health, Astrid Lindgren Children's Hospital, Karolinska Institute, Stockholm, Sweden; and the
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Karin Stjernqvist
§Departments of Pediatrics and Psychology, University of Lund, Lund, Sweden.
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Hugo Lagercrantz
‡Neonatal Programme, Department of Woman and Child Health, Astrid Lindgren Children's Hospital, Karolinska Institute, Stockholm, Sweden; and the
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Abstract

Background and Objective. Family-centered developmentally supportive care of very low birth weight infants, provided by the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been reported to have positive medical and economic impacts. Our aim was to investigate its effect on need of ventilatory assistance, growth, and hospitalization in a Swedish setting.

Methods. Preterm infants born between September 1994 and April 1997 with a gestational age <32 weeks and with a need of ventilatory assistance at 24 hours were randomly assigned to either NIDCAP (n = 12) or conventional care (n = 13). The 2 groups were comparable (median [range]) with respect to birth weight (1083 [630–1411] vs 840[636–1939 g]), head circumference (24.0 [22.3–26.5] vs 24.0 [21.1–30.0 cm]), gestational age (27.6 [24.0–28.7] vs 26.1 [23.9–30.3] weeks), female/male ratio (3/9 vs 9/8) and Clinical Risk Index for Babies (4.0 [0–11] vs 6.0 [2–15]). The infants in the intervention group were cared for in a separate room by a group of specially trained nurses. Formal weekly observations of these infants starting within 3 days after birth and continuing until 36 weeks postconception were used to develop individualized care plans. These plans provided recommendations as to how care might be attuned to the current developmental stage of the infant and how the family might be supported and stimulated to participate in this care. The treatment of the 2 groups was in all other respects identical.

Results. The duration of mechanical ventilation (median [range] was 2.8 [0–36.7] days in the intervention group vs 4.8 [.1–29.8] days; not significant [NS]) among the controls and continuous positive airway pressure was applied for 26.1 (6.9–52.0) vs 43.9 (5.0–65.1) days. Supplementary oxygen was withdrawn at 33.0 (29.3–35.7) vs 38.1 (33.1–44.9) weeks of postconceptional age (PCA). The weight gain up to 35 weeks of PCA was 13.0 (6.7–21.0) vs 9.8 (6.8–16.6) g/day (NS). The head growth up to 35 weeks of PCA was .73 (.56–1.3) vs .63 (.56-.77) cm/week (NS). The age of the infant at discharge was 38.3 (36.1–57.7) vs 41.0 (36.9–48.4) weeks of PCA (NS).

Conclusions. NIDCAP does not seem to have detrimental effects on Swedish very low birth weight infants in comparison with conventional care. Indeed, NIDCAP might even be advantageous.

  • infant
  • very low birth weight growth and development infant
  • low birth weight infant
  • newborn infant
  • premature growth and development infant
  • premature infant
  • premature
  • diseases nursing infant
  • premature
  • diseases prevention and control
  • intensive care units
  • neonatal standards intensive care units
  • neonatal utilization intensive care
  • neonatal methods intensive care
  • neonatal nursing methods
  • neonatal nursing standards
  • patient care planning standards
  • bronchopulmonary dysplasia/prevention and control/therapy
  • human
  • Received February 9, 1999.
  • Accepted August 23, 1999.
  • Copyright © 2000 American Academy of Pediatrics

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Pediatrics
Vol. 105, Issue 1
1 Jan 2000
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A Randomized, Controlled Trial to Evaluate the Effects of the Newborn Individualized Developmental Care and Assessment Program in a Swedish Setting
Björn Westrup, Agneta Kleberg, Kristina von Eichwald, Karin Stjernqvist, Hugo Lagercrantz
Pediatrics Jan 2000, 105 (1) 66-72; DOI: 10.1542/peds.105.1.66

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A Randomized, Controlled Trial to Evaluate the Effects of the Newborn Individualized Developmental Care and Assessment Program in a Swedish Setting
Björn Westrup, Agneta Kleberg, Kristina von Eichwald, Karin Stjernqvist, Hugo Lagercrantz
Pediatrics Jan 2000, 105 (1) 66-72; DOI: 10.1542/peds.105.1.66
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  • Joint observation in NICU (JOIN): study protocol of a clinical randomised controlled trial examining an early intervention during preterm care
  • NIDCAP in preterm infants and the neurodevelopmental effect in the first 2 years
  • NIDCAP: A Systematic Review and Meta-analyses of Randomized Controlled Trials
  • Level of NICU Quality of Developmental Care and Neurobehavioral Performance in Very Preterm Infants
  • The Stockholm Neonatal Family Centered Care Study: Effects on Length of Stay and Infant Morbidity
  • Improvement of Short- and Long-Term Outcomes for Very Low Birth Weight Infants: Edmonton NIDCAP Trial
  • NIDCAP: Testing the Effectiveness of a Relationship-Based Comprehensive Intervention
  • Effects of Individualized Developmental Care in a Randomized Trial of Preterm Infants <32 Weeks
  • Follow-up Outcomes at 1 and 2 Years of Infants Born Less Than 32 Weeks After Newborn Individualized Developmental Care and Assessment Program
  • No change in developmental outcome with incubator covers and nesting for very preterm infants in a randomised controlled trial
  • Developmental Interventions in the NICU: What are the Developmental Benefits?
  • Lower Stress Responses After Newborn Individualized Developmental Care and Assessment Program Care During Eye Screening Examinations for Retinopathy of Prematurity: A Randomized Study
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Keywords

  • infant
  • very low birth weight growth and development infant
  • low birth weight infant
  • newborn infant
  • premature growth and development infant
  • premature infant
  • premature
  • diseases nursing infant
  • diseases prevention and control
  • intensive care units
  • neonatal standards intensive care units
  • neonatal utilization intensive care
  • neonatal methods intensive care
  • neonatal nursing methods
  • neonatal nursing standards
  • patient care planning standards
  • bronchopulmonary dysplasia/prevention and control/therapy
  • human
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