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A Randomized Trial of Baby Triple P for Preterm Infants: Child Outcomes at 2 Years of Corrected Age

Paul B Colditz¹, Roslyn N Boyd², Leanne Winter³

¹University of Queensland Center for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Royal Brisbane and Women's Hospital, Brisbane, Australia.

The Journal of Pediatrics

|March 13, 2019

Insights

A hospital-based intervention improved cognitive and motor skills in infants born before 32 weeks gestation. However, the intervention did not significantly impact child behavior outcomes at two years corrected age.

Area of Science:

Neonatal development
Developmental psychology
Evidence-based parenting interventions

Background:

Infants born preterm (<32 weeks gestation) face risks for developmental delays.
Early interventions are crucial for improving long-term outcomes in this vulnerable population.
Transitioning hospital-based support to community resources can enhance intervention sustainability.

Purpose of the Study:

To evaluate the efficacy of a hospital-based intervention transitioning to community support.
To enhance developmental outcomes at 2 years corrected age in infants born <32 weeks gestation.
To assess the intervention's impact on cognitive, language, motor, and behavioral development.

Main Methods:

Randomized controlled trial involving 323 families of infants born <32 weeks.
Intervention group received parenting skills training over 4 hospital and 4 phone sessions.
Developmental outcomes assessed at 2 years corrected age using standardized scales (Bayley Scales, Infant and Toddler Social Emotional Adjustment Scale).

Main Results:

No significant differences in child behavior (dysregulation, externalizing, internalizing) between groups.
Intervention group showed significantly higher scores in cognition (P=0.04) and motor skills (P<0.001).
Language skills approached significance (P=0.07) in the intervention group.

Conclusions:

The Baby Triple P for Preterm Infants intervention enhances cognitive and motor skills in preterm infants.
The intervention did not demonstrate significant effects on behavioral outcomes.
Hospital-based interventions can positively influence specific developmental trajectories for high-risk infants.

Read full analysis

Abstract

Objective:

To determine the efficacy of a hospital-based intervention that transitions into existing community support, in enhancing developmental outcomes at 2 years of corrected age in infants born at less than 32 weeks.

Study Design:

In total, 323 families of 384 infants born <32 weeks were randomized to receive intervention or care-as-usual. The intervention teaches parents coping skills, partner support, and effective parenting strategies over 4 hospital-based and 4 home-phone sessions. At 2 years of corrected age maternally reported child behavior was assessed by the Infant and Toddler Social Emotional Adjustment Scale. Observed child behavior was coded with the Revised Family Observation Schedule. Cognitive, language, and motor skills were assessed with the Bayley Scales of Infant and Toddler Development III.

Results:

Mean gestational age of infants was 28.5 weeks (SD = 2.1), and mothers' mean age was 30.6 years (SD = 5.8). A total of 162 families (n = 196 infants) were allocated to intervention and 161 families (n = 188 infants) received care-as-usual. There was no significant adjusted difference between treatment groups on dysregulation (0.2; 95% CI -2.5 to 3.0, P = .9) externalizing (0.3; 95% CI -1.6 to 2.2, P = .8), internalizing (-1.5; 95% CI -4.3 to 1.3, P = .3), observed aversive (0.00; -0.04 to 0.04, P = .9), or nonaversive behavior (-0.01; 95% CI -0.05 to 0.03, P = .7). Intervention children scored significantly higher on cognition (3.5; 95% CI 0.2-6.8, P = .04) and motor skill (5.5; 95% CI 2.5-8.4, P < .001), and approached significance on language (3.8; 95% CI -0.3 to 7.9, P = .07).

Conclusions:

Baby Triple P for Preterm Infants increases cognitive and motor skills but does not impact behavior. The results are evidence that hospital-based interventions can improve some developmental outcomes for infants <32 weeks.

Trial Registration:

ACTRN 12612000194864.

Keywords:

intervention parenting

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