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Developmental care for promoting development and preventing morbidity in preterm infants
1The Children's Hospital, Hamilton Health Sciences, Children's Hospital Neonatal Unit - MUMC 4G, 1200 Main St. West, Hamilton, Ontario, Hamilton-Wentworth, Canada, L8N 3Z5. symington@hhsc.ca
The Cochrane Database of Systematic Reviews
|November 1, 2001
Summary
Developmental care interventions show some benefits for preterm infants, including improved growth and reduced hospital stays. However, more consistent evidence is needed to confirm effects on various clinical outcomes.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Evidence-based medicine
Background:
- Preterm infants face significant morbidity due to organ immaturity and disease.
- Neonatal intensive care unit (NICU) environments can exacerbate infant morbidity.
- Developmental care interventions aim to minimize NICU-related stress through environmental modifications.
Purpose of the Study:
- To evaluate the effectiveness of developmental care interventions in preterm infants.
- To assess impacts on neurodevelopmental delay, growth, hospital stay, and ventilation duration.
- To identify clinically relevant adverse outcomes associated with these interventions.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) published in English.
- Searches conducted in Medline, CINAHL, and The Cochrane Library up to July 2000.
- Inclusion criteria: infants < 37 weeks gestation, comparison to routine care, clinically relevant outcomes.
Main Results:
- 31 RCTs identified, covering four major intervention groups and 19 sub-groups.
- Developmental care showed benefits in short-term growth, reduced respiratory support, shorter hospital stays, and improved neurodevelopmental outcomes up to 24 months corrected age.
- Findings were based on small trials, with methodological limitations like lack of blinding in half the studies.
Conclusions:
- Developmental care interventions offer some benefits to preterm infants, with no major adverse effects reported.
- Difficulty in determining individual intervention effects due to combined interventions in studies.
- Further research with consistent findings on short- and long-term outcomes is needed; economic impact should be considered.