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Updated: Nov 7, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Effectiveness of interventions on early neurodevelopment of preterm infants: a systematic review and meta-analysis
Marilyn Aita1,2,3, Gwenaëlle De Clifford Faugère4,5, Andréane Lavallée4,5
1Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, Montréal, QC, H3C 3J7, Canada. marilyn.aita@umontreal.ca.
Insights
The Neonatal Individualized Developmental Care and Assessment Program (NIDCAP) intervention shows promise for improving preterm infants' neurodevelopment. However, evidence for other NICU interventions remains limited, necessitating further research for optimal infant care.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Evidence-based medicine
Background:
- Preterm infant neurodevelopment is significantly influenced by Neonatal Intensive Care Unit (NICU) hospitalization factors.
- Evaluating the efficacy of NICU-based interventions is crucial for optimizing early neurodevelopmental outcomes.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of interventions initiated during NICU hospitalization on preterm infants' neurodevelopment.
- To assess outcomes during hospitalization and up to two weeks corrected age (CA).
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines, registered in PROSPERO (CRD42017047072).
- Searched multiple databases (CINAHL, MEDLINE, PubMed, EMBASE, Cochrane, CENTRAL, Web of Science) from 2002 to February 2020.
- Included randomized controlled trials involving preterm infants (24-366/7 weeks gestation) and all intervention types initiated during NICU stay.
Main Results:
- Meta-analysis of three studies indicated NIDCAP improves neurobehavioral and neurological development at two weeks CA compared to standard care.
- Meta-analysis of two studies found parental participation did not significantly enhance neurobehavioral development during NICU hospitalization.
- Other interventions (developmental care, sensory stimulation, music, physical therapy) showed controversial or partially effective results.
Conclusions:
- The overall quality of evidence supporting these interventions is low to very low.
- Further research is required to identify the most effective interventions for promoting early neurodevelopment in preterm infants.
- Future studies should employ standardized designs and comprehensive assessment tools for robust comparisons.
Background:
As preterm infants' neurodevelopment is shaped by NICU-related factors during their hospitalization, it is essential to evaluate which interventions are more beneficial for their neurodevelopment at this specific time. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of interventions initiated during NICU hospitalization on preterm infants' early neurodevelopment during their hospitalization and up to two weeks corrected age (CA).
Methods:
This systematic review referred to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines and was registered in PROSPERO (CRD42017047072). We searched CINAHL, MEDLINE, PubMed, EMBASE (OVID), Cochrane Systematic Reviews, CENTRAL, and Web of Science from 2002 to February 2020 and included randomized controlled/clinical trials conducted with preterm infants born between 24 and 366/7 weeks of gestation. All types of interventions instigated during NICU hospitalization were included. Two independent reviewers performed the study selection, data extraction, assessment of risks of bias and quality of evidence.
Results:
Findings of 12 studies involving 901 preterm infants were synthesized. We combined three studies in a meta-analysis showing that compared to standard care, the NIDCAP intervention is effective in improving preterm infants' neurobehavioral and neurological development at two weeks CA. We also combined two other studies in a meta-analysis indicating that parental participation did not significantly improve preterm infants' neurobehavioral development during NICU hospitalization. For all other interventions (i.e., developmental care, sensory stimulation, music and physical therapy), the synthesis of results shows that compared to standard care or other types of comparators, the effectiveness was either controversial or partially effective.
Conclusions:
The overall quality of evidence was rated low to very low. Future studies are needed to identify interventions that are the most effective in promoting preterm infants' early neurodevelopment during NICU hospitalization or close to term age. Interventions should be appropriately designed to allow comparison with previous studies and a combination of different instruments could provide a more global assessment of preterm infants' neurodevelopment and thus allow for comparisons across studies.
Trial Registration:
Prospero CRD42017047072 .
