Related Experiment Videos
The Newborn Individualized Developmental Care and Assessment Program is not supported by meta-analyses of the data
Susan E Jacobs1, Jennifer Sokol, Arne Ohlsson
1Division of Neonatology, Department of Pediatrics, the Hospital for Sick Children and Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Insights
The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) shows limited benefits for preterm infants, with no long-term improvements in neurodevelopmental outcomes. Further research is needed to confirm its effectiveness.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Evidence-based medicine
Background:
- Preterm and low birth weight infants face significant neurodevelopmental challenges.
- Individualized developmental care aims to mitigate these risks.
- The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is a structured approach to developmental care.
Purpose of the Study:
- To systematically review the effectiveness of NIDCAP compared to conventional care.
- To assess NIDCAP's impact on short-term medical and neurodevelopmental outcomes.
- To evaluate NIDCAP's potential for improving long-term neurodevelopmental outcomes in vulnerable infants.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) and prospective cohort studies.
- Inclusion of studies on NIDCAP for preterm and/or low birth weight infants.
- Meta-analysis of dichotomous and continuous data using standard statistical methods.
Main Results:
- Five RCTs and three cohort studies met the inclusion criteria.
- NIDCAP demonstrated a statistically significant benefit in reducing the need for supplemental oxygen.
- Neurodevelopmental outcomes improved at 9-12 months but not at 2 years; school-age outcomes remain unreported.
Conclusions:
- Current evidence is insufficient to support NIDCAP for improving medical and neurodevelopmental outcomes in preterm infants.
- Long-term neurodevelopmental outcomes after NIDCAP require further investigation.
- More high-quality research is needed to establish the definitive benefits of NIDCAP.
Objectives:
To systematically review the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) as compared with conventional care to improve long-term neurodevelopmental outcomes or short-term medical and neurodevelopmental outcomes in preterm and/or low birth weight infants.
Study Design:
With the use of standard systematic review methodology, all randomized, controlled trials (RCTs) and prospective cohort studies evaluating in-hospital developmental care based on the framework of NIDCAP in preterm and/or low birth weight infants were identified. The quality of the RCTs was assessed. Meta-analyses were performed by using relative risk and risk difference for dichotomous data and weighted mean difference for continuous data with 95% confidence intervals.
Results:
Five RCTs (n = 136) and 3 phase-lag cohort studies (n = 185) met inclusion criteria. School-age neurodevelopmental outcomes after NIDCAP have not been reported. Meta-analyses of medical outcomes showed a statistically significant benefit of NIDCAP on requirement for supplemental oxygen. Neurodevelopmental outcome was improved at 9 or 12 months but not at 2 years.
Conclusions:
There is insufficient evidence to support the NIDCAP to improve medical and neurodevelopmental outcomes of preterm infants.