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Updated: Nov 1, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Family integrated care: very preterm neurodevelopmental outcomes at 18 months
Anne R Synnes1,2, Julie Petrie3, Ruth E Grunau2,4
1Neonatology, British Columbia Women's Hospital and Health Centre, Vancouver, British Columbia, Canada Anne.Synnes@bcchr.ca.
Insights
The Family Integrated Care (FICare) program for very preterm infants showed no impact on cognitive or language development. However, FICare did lead to improved motor development and growth in these vulnerable infants.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Neuroscience
Background:
- The Family Integrated Care (FICare) program engages parents as primary caregivers in the neonatal intensive care unit (NICU).
- Previous research has explored the impact of parental involvement on infant outcomes.
- This study builds upon a cluster randomized control trial (cRCT) registered under NCT01852695.
Purpose of the Study:
- To evaluate the effect of the FICare program on neurodevelopment and growth in infants born before 29 weeks' gestational age at 18 months' corrected age.
- To determine if parental engagement in the NICU influences long-term infant outcomes.
Main Methods:
- A prospective cohort study involving infants born <29 weeks' gestational age from the FICare cRCT.
- Neurodevelopment and growth assessed at 18 months' corrected age using the Bayley-III scale and BMI.
- Logistic regression and generalized estimation equations used for statistical analysis, adjusted for confounders.
Main Results:
- No significant difference in the primary outcome (Cognitive or Language composite score <85) between FICare and control groups.
- FICare infants showed a higher incidence of intraventricular hemorrhage (IVH) and a higher proportion of employed mothers.
- Significantly higher Bayley-III Motor scores and body mass index (BMI) observed in the FICare group compared to controls.
Conclusions:
- The FICare program did not significantly affect cognitive or language development in very preterm infants.
- FICare exposure was associated with enhanced motor development and improved growth (BMI) in this cohort.
- Parental integration in NICU care may positively influence specific developmental trajectories in extremely preterm infants.
Objective:
To examine whether the family integrated care (FICare) programme, a multifaceted approach which enables parents to be engaged as primary caregivers in the neonatal intensive care unit, impacts infant neurodevelopment and growth at 18 months' corrected age.
Design/Methods:
Prospective cohort study of infants born <29 weeks' gestational age (GA) who participated in the FICare cluster randomised control trial (cRCT) and were assessed in the Canadian Neonatal Follow-Up Network (CNFUN). The primary outcome measure, Cognitive or Language composite score <85 on the Bayley-III, was compared between FICare exposed and routine care children using logistic regression, adjusted for potential confounders and employing generalised estimation equations to account for clustering of infants within sites.
Results:
Of 756 infants <29 weeks' GA in the FICare cRCT, 505 were enrolled in CNFUN and 455 were assessed (238 FICare, 217 control). Compared with controls, FICare infants had significantly higher incidence of intraventricular haemorrhage (IVH) (19.5% vs 11.7%, p=0.024) and higher proportion of employed mothers (76.6% vs 73.6%, p=0.043). There was no significant difference in the odds of the primary outcome (adjusted OR: 0.92 (0.59 to 1.42) FiCare vs Control) on multivariable analyses adjusted for GA, IVH and maternal employment. However, Bayley-III Motor scores (adjusted difference in mean (95% CI) 3.87 (1.22 to 6.53) and body mass index 0.67 (0.36 to 0.99) were higher in the FICare group.
Conclusions:
Very preterm infants exposed to FICare had no significant difference in incidence of cognitive or language delay but had better motor development.
Trial Registration Number:
Participants in this cohort study were previously enrolled in a registered trial: NCT01852695.
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