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Rethinking preventive post-discharge intervention programmes for very preterm infants and their parents
Aleid G van Wassenaer-Leemhuis1, Martine Jeukens-Visser2, Janeline W P van Hus2
1Department of Neonatology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
Insights
Post-discharge family-centered interventions enhance very preterm infant development and resilience. These programs, supporting responsive parenting and maternal well-being, show modest but lasting cognitive and motor improvements.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Public health interventions
Background:
- Infants born very preterm face developmental challenges.
- Post-discharge support is crucial for their resilience and long-term outcomes.
- Family-centered interventions show promise in addressing these needs.
Purpose of the Study:
- To review the content and effects of home-based, family-centered intervention programs for very preterm infants.
- To assess the long-term impact of these interventions on cognitive and motor development.
- To identify key components for effective post-discharge support.
Main Methods:
- A narrative review of six randomized controlled trials of home-based, family-centered intervention programs.
- Updated systematic review data to compare program content and effects over time.
- Focused on interventions aiming to improve cognitive outcomes by age two.
Main Results:
- Four of the six reviewed programs improved child cognitive and/or motor development.
- Interventions emphasizing responsive parenting yielded cognitive improvements up to 5 years post-program.
- Programs addressing maternal anxiety improved maternal well-being and child behavior, with effects lasting up to 3 years.
Conclusions:
- Family-centered preventive interventions post-discharge are vital for preterm infant resilience.
- Effective programs support the parent-infant relationship and parental well-being.
- Modest but sustained improvements in development and behavior are achievable.
Abstract:
Post-discharge preventive intervention programmes with involvement of the parent may support the resilience and developmental outcomes of infants born very preterm. Randomized controlled trials of home-based family-centred intervention programmes in very preterm infants that aimed to improve cognitive outcome, at least at age two, were selected and updated on the basis of a recent systematic review to compare their content and effect over time to form the basis of a narrative review. Six programmes were included in this narrative review. Four of the six programmes led to improved child cognitive and/or motor development. Two programmes, which focused primarily on responsive parenting and development, demonstrated improved cognitive outcome up till 5 years after completion of the programme. The programmes that also focused on maternal anxiety remediation led to improved maternal mental well-being, along with improved child behaviour, in one study - even at 3 years after completion of the programme. The magnitude of the effects was modest. Family-centred preventive intervention programmes that aim at improvement of child development should be continued after discharge home to improve the preterm child's resilience. Programmes may be most effective when they support the evolvement of a responsive parent-infant relationship over time, as well as the parent's well-being.
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