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Effect of Model of Neonatal Care on Neurodevelopment at the 18 Month Follow-Up in Moderate and Late Preterm Infants
Karen M Benzies1, Fiona C Bartram2, Deborah A McNeil3
1Faculty of Nursing and Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.
Insights
The Alberta Family Integrated Care (FICare) model did not reduce developmental delay in moderate to late preterm infants. However, maternal parenting stress was linked to a higher risk of developmental delay in these infants.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Maternal mental health
Background:
- Preterm birth, including moderate and late preterm infants (MLPIs), poses risks for long-term developmental challenges.
- Family Integrated Care (FICare) models aim to enhance neonatal outcomes by involving parents in infant care.
- The Alberta FICare model was implemented in Canadian NICUs to assess its impact.
Purpose of the Study:
- To evaluate the association between the Alberta FICare model and the risk of developmental delay in MLPIs at 18 months corrected age (CA).
- To explore the impact of maternal psychosocial distress on developmental outcomes in MLPIs.
Main Methods:
- A cluster randomized controlled trial involving 257 mothers and 298 infants across ten Level II NICUs in Alberta, Canada.
- Developmental screening tests were used to assess the risk of delay.
- Maternal psychosocial distress was measured using validated self-report scales for depressive symptoms, anxiety, parenting stress, and self-efficacy.
Main Results:
- No significant association was found between the Alberta FICare model of care and the risk of developmental delay at 18 months CA.
- Elevated maternal parenting stress was significantly associated with an increased risk of developmental delay in MLPIs.
Conclusions:
- The Alberta FICare model did not demonstrate a reduction in developmental delay risk for MLPIs at 18 months CA.
- Maternal parenting stress is a critical factor influencing the development of MLPIs and warrants attention post-discharge.
Abstract:
Background: Preterm birth, even for moderate or late preterm infants (MLPIs), is associated with longer-term developmental challenges. Family Integrated Care (FICare) models of care, like Alberta FICare, aim to improve outcomes by integrating parents into neonatal care during hospitalization. This follow-up study examined the association between models of care (Alberta FICare versus standard care) and risk of child developmental delay at 18 months corrected age (CA) and explored the influences of maternal psychosocial distress. Methods: We assessed 257 mothers and 298 infants from a cluster randomized controlled trial (ID: NCT0279799) conducted in ten Level II NICUs in Alberta, Canada. Risk of delay was assessed using developmental screening tests. Maternal psychosocial distress was assessed using self-reported measures of depressive symptoms, anxiety, parenting stress, and self-efficacy. Results: There was no association between model of care and risk of developmental delay. Higher maternal parenting stress was associated with increased risk of developmental delay. Conclusions: Alberta FICare was not associated with decreased risk of developmental delay at 18 months CA. Maternal parenting stress may play an important role in the development of MLPIs and should be addressed post-discharge.
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