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Cognitive outcome of early intervention in preterms at 7 and 9 years of age: a randomised controlled trial
Lisbeth Hauglann1, Bjørn Helge Handegaard2, Stein Erik Ulvund3
1Division of Child and Adolescent Health, Department of Child and Adolescent Psychiatry, University Hospital of North Norway, Tromsø, Norway.
Insights
An early intervention program for preterm infants did not significantly improve cognitive outcomes at ages 7 and 9. While some verbal scores showed a slight advantage at age 7, overall cognitive development remained similar between groups.
Area of Science:
- Neonatal care and developmental pediatrics.
- Child psychology and cognitive development.
Background:
- Children born with low birth weight (<2000g) are at risk for cognitive deficits.
- Early intervention programs aim to mitigate these risks and improve developmental trajectories.
Purpose of the Study:
- To evaluate the long-term cognitive effects of an early intervention program in preterm children.
- To assess outcomes at 7 and 9 years of age.
Main Methods:
- A randomized controlled trial involving 146 preterm infants (<2000g BW).
- Intervention group received targeted sessions and home visits focusing on infant characteristics and parent-infant interaction.
- Cognitive outcomes were measured using the Wechsler Intelligence Scale for Children (WISC-III).
Main Results:
- No significant differences in WISC-III scores were observed at 7 or 9 years between intervention and control groups.
- A trend favored the intervention group at 7 years (mean difference 4.1 points) and 9 years (mean difference 2.2 points).
- A significant difference favoring the intervention group was noted in the Verbal Comprehension Index at 7 years (6.8 points).
Conclusions:
- The tested early intervention program did not demonstrate a sustained significant impact on overall cognitive outcomes for preterm children.
- While some specific verbal abilities showed short-term benefits, long-term cognitive development was not significantly altered.
Objective:
Examine the effect of an early intervention programme on cognitive outcome at 7 and 9 years in children with birth weight (BW) <2000 g.
Design:
A randomised controlled trial of a modified version of the Mother-Infant Transaction Program.
Setting:
A single tertiary neonatal unit.
Patients:
146 infants were randomised into a preterm control group (74) or a preterm intervention group (72).
Interventions:
The intervention consisted of eight sessions shortly before discharge and four home visits by specially trained nurses focusing on the infants' unique characteristics, temperament, developmental potential and the interaction between infants and parents.
Main Outcome Measures:
Outcomes were assessed with the Wechsler Intelligence Scale for Children (WISC-III).
Results:
Mean BWs were 1396 (429) g in the intervention group and 1381(436) g in the control group. After adjusting for the possible clustering effects of twin pairs and maternal education, there were no significant differences in WISC-III scores at age 7 or 9. The mean difference was 4.1 points (95% CI -1.5 to 9.8 points) in favour of the intervention group at 7 years and 2.2 points (95% CI -3.4 to 7.6 points) at 9 years. At 7 years, a 6.8 points difference in the Verbal Comprehension Index (95% CI 0.5 to 13.0 points) was found in favour of the intervention group. Loss to follow-up at age 7 and 9 was 11% and 14%, respectively.
Conclusions:
This intervention programme did not have a sustained significant effect on overall cognitive outcomes in preterm children at age 7 and 9.
Trial Registration Number:
The trial has been registered at http://www.clinicaltrials.gov (identifier NCT00222456).
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