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Exploring Effect of Postdischarge Developmental Support Program on Preterm Infant Neurodevelopment and BDNF Gene DNA
Jun Zhang1, Mi Cao, Shaoting Yue
1Faculty of Nursing (Dr Zhang), Wuhan University School of Nursing, Wuhan, China (Messrs Yan and Cao); Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China (Ms Yue); and Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China (Ms Shang).
Insights
A Postdischarge Developmental Support Program (PDSP) improved preterm infant neurodevelopment. However, this pilot study found no significant effect on brain-derived neurotrophic factor (BDNF) gene methylation or expression at three months corrected age.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Epigenetics
Background:
- Developmental supportive care improves preterm infant outcomes.
- Limited research exists on after-discharge developmental support.
- Epigenetic changes related to such support are not well understood.
Purpose of the Study:
- To investigate the preliminary effects of a Postdischarge Developmental Support Program (PDSP).
- To assess PDSP's impact on preterm infant neurodevelopment.
- To explore PDSP's influence on epigenetic factors, specifically BDNF gene methylation and expression.
Main Methods:
- A randomized controlled pilot trial involving 44 preterm infant-parent dyads.
- Intervention group received PDSP; control group received usual care.
- Neurodevelopment assessed using Ages & Stages Questionnaires; BDNF levels measured via ELISA and gene methylation analysis.
Main Results:
- The PDSP group showed significantly higher neurodevelopmental scores compared to the control group.
- BDNF levels decreased significantly in the control group but not the intervention group.
- No statistically significant differences in BDNF concentration or methylation levels were observed between the groups.
Conclusions:
- PDSP may enhance neurodevelopment in preterm infants.
- PDSP did not significantly affect BDNF expression or gene methylation at 3 months corrected age.
- Further research with larger samples and longer follow-up is needed to elucidate PDSP's epigenetic mechanisms.
Background:
Although developmental supportive care is an effective approach to improve the long-term psychomotor and/or neurobehavioral function of preterm infants, very limited studies have focused on the impact of after-discharge developmental support. The underlying epigenetic changes are unclear.
Purpose:
This study aimed to explore the preliminary effect of an evidence-based Postdischarge Developmental Support Program (PDSP) on preterm infant neurodevelopment and underlying epigenetic changes, including brain-derived neurotrophic factor (BDNF) gene-related DNA methylation and expression.
Methods:
In this randomized controlled pilot trial, the preterm infant-parent dyads were randomized into either the intervention group/PDSP group (n = 22) or the control group/usual care group (n = 22). The neurodevelopmental outcomes of preterm infants were measured by Ages & Stages Questionnaires. Urine BDNF concentration level was tested by the enzyme-linked immunosorbent assay. Infant saliva specimens were collected to analyze the methylation level of BDNF gene promoter I at pre- and postintervention test.
Results:
After PDSP intervention, the total neurodevelopmental and the 5 domain scores of the PDSP group were all significantly higher than those of the control group ( P < .05). The BDNF levels decreased significantly only within control group ( P = .01). The difference in BDNF concentration and methylation levels between groups was not statistically significant.
Implications For Practice And Research:
Postdischarge Developmental Support Program may promote the neurodevelopment of preterm infants but has no effect on BDNF's expression and gene methylation level at 3 months of corrected age. The epigenetic mechanism of PDSP needs further study using a larger sample and longer follow-up.
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