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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Behavioural and cognitive outcomes following an early stress-reduction intervention for very preterm and extremely
Jeannette Milgrom1,2, Paul R Martin3, Carol Newnham1
1Parent-Infant Research Institute, Department of Clinical & Health Psychology, Austin Health, Melbourne, VIC, 3081, Australia.
Insights
Parent-sensitivity training did not improve neurobehavioural outcomes in very preterm infants up to preschool age. Advances in neonatal intensive care may limit the impact of such interventions.
Area of Science:
- Neonatal care
- Developmental psychology
- Pediatric neurodevelopment
Background:
- The Mother-Infant Transaction Program (MITP) previously showed improved neurodevelopment in preterm infants.
- Replication of MITP's success has been inconsistent.
- This study investigates an MITP-type intervention's long-term effects.
Purpose of the Study:
- To evaluate a parent-sensitivity intervention (PremieStart) based on MITP principles.
- To assess neurobehavioural development in very preterm infants until preschool age.
- To determine if the intervention impacts behavior, general development, cognitive, and executive functioning.
Main Methods:
- A randomized controlled trial included 123 very preterm infants.
- Infants were assigned to either the PremieStart intervention (n=60) or standard care (n=63).
- Neurobehavioural outcomes were assessed at 2 and 4.5 years using validated scales (Bayley-III, WPPSI-III, NEPSY-II, CBCL).
Main Results:
- No significant differences were found in behavior problems at 2 or 4.5 years between groups.
- General development at 2 years showed no significant group differences.
- Cognitive and executive functioning at 4.5 years did not differ significantly between the intervention and control groups.
Conclusions:
- Improved neonatal intensive care quality may reduce the additional benefits of MITP-type interventions.
- Gestational age and intervention timing could influence the efficacy of such programs.
- Further research is needed to optimize interventions for preterm infants' long-term outcomes.
Background:
The landmark findings of the Mother-Infant Transaction Program (MITP) showing improved neurodevelopment of preterm infants following parent-sensitivity training delivered in the neonatal intensive care unit have not been consistently replicated. This study evaluated an MITP-type intervention in terms of neurobehavioural development to preschool age.
Methods:
A randomised controlled trial involved 123 very preterm and extremely preterm infants allocated to either a parent-sensitivity intervention (PremieStart, n = 60) or to standard care (n = 63). When children were 2 and 4.5 years corrected age, parents completed the Child Behavior Checklist (CBCL). General development was assessed at 2 years with the Bayley Scales of Infant Development (Bayley-III). At 4.5 years, cognitive functioning was assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and executive functioning with the NEPSY-II.
Results:
There were no significant between-group differences in behaviour problems at 2 or 4.5 years, general development at 2 years, or cognitive and executive functioning at 4.5 years.
Conclusion:
Advances in the quality of neonatal intensive care may mean that MITP-type interventions now have limited additional impact on preterm infants' long-term neurobehavioural outcomes. The gestational age of infants and the exact timing of intervention may also affect its efficacy.
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