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School-Age Outcomes of Early Intervention for Preterm Infants and Their Parents: A Randomized Trial
Alicia J Spittle1,2,3, Sarah Barton4, Karli Treyvaud4,3,5,6
1Victorian Infant Brain Study, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; aspittle@unimelb.edu.au.
Insights
A home-based early preventive care program for very preterm infants showed minimal long-term effects on child neurodevelopment. However, parents in the intervention group experienced significant reductions in depression symptoms.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Public Health
Background:
- Infants born very preterm (<30 weeks gestation) face risks for neurodevelopmental challenges.
- Early intervention programs aim to mitigate these risks and support parental well-being.
- Long-term outcomes of such programs require rigorous evaluation.
Purpose of the Study:
- To assess the school-age child and parental outcomes of a home-based early preventative care program for very preterm infants.
- To evaluate the long-term neurodevelopmental and mental health effects of the intervention.
Main Methods:
- A randomized controlled trial involving 120 infants born <30 weeks gestation, allocated to intervention or standard care.
- Intervention included 9 home visits in the first year focusing on infant development, parental mental health, and parent-infant relationship.
- Outcomes assessed at 8 years corrected age included child cognitive, behavioral, motor functioning, and parental mental health.
Main Results:
- Children in the intervention group showed reduced mathematics difficulties (OR 0.42, P=.045) but no significant effects on other developmental outcomes.
- Parents in the intervention group reported fewer depression symptoms (mean difference -2.7, P<.001) and reduced odds of depression (OR 0.14, P=.0152).
- Follow-up included 100 children (85% of survivors).
Conclusions:
- The early preventive care program had minimal long-term neurodevelopmental effects on children born very preterm.
- The program demonstrated significant benefits for parental mental health, specifically reducing depression.
- These findings highlight the importance of parental support within early intervention strategies.
Objective:
To examine the child and parental outcomes at school age of a randomized controlled trial of a home-based early preventative care program for infants born very preterm and their caregivers.
Methods:
At term-equivalent age, 120 infants born at a gestational age of <30 weeks were randomly allocated to intervention (n = 61) or standard care (n = 59) groups. The intervention included 9 home visits over the first year of life focusing on infant development, parental mental health, and the parent-infant relationship. At 8 years' corrected age, children's cognitive, behavioral, and motor functioning and parental mental health were assessed. Analysis was by intention to treat.
Results:
One hundred children, including 13 sets of twins, attended follow-up (85% follow-up of survivors). Children in the intervention group were less likely to have mathematics difficulties (odds ratio, 0.42; 95% confidence interval [CI], 0.18 to 0.98; P = .045) than children in the standard care group, but there was no evidence of an effect on other developmental outcomes. Parents in the intervention group reported fewer symptoms of depression (mean difference, -2.7; 95% CI, -4.0 to -1.4; P < .001) and had reduced odds for mild to severe depression (odds ratio, 0.14; 95% CI, 0.03 to 0.68; P = .0152) than parents in the standard care group.
Conclusions:
An early preventive care program for very preterm infants and their parents had minimal long-term effects on child neurodevelopmental outcomes at the 8-year follow-up, whereas primary caregivers in the intervention group reported less depression.
