Developmental care for promoting development and preventing morbidity in preterm infants

Area of Science:

• Neonatal Medicine
• Developmental Pediatrics
• Evidence-Based Practice

Background:

• Preterm infants face significant morbidity due to organ immaturity and disease.
• The neonatal intensive care unit (NICU) environment can exacerbate infant morbidity.
• Developmental care interventions aim to minimize NICU-related stress and iatrogenic effects.

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 other adverse outcomes.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) published up to July 2003.
• Searches included MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials.
• Included RCTs compared developmental care to routine nursery care for infants < 37 weeks gestation.

Main Results:

• Developmental care showed benefits in short-term growth, feeding, reduced respiratory support, and shorter hospital stays.
• Neurodevelopmental outcomes improved up to 24 months corrected age.
• Many findings were based on small trials, with methodological limitations like lack of blinding.

Conclusions:

• Overall, developmental care interventions show some benefits for preterm infants without major reported harm.
• Difficulty in isolating effects of single interventions due to combined approaches in studies.
• Further research with consistent outcomes is needed to guide practice; economic impact requires consideration.