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Preventive care program benefits preterm infants, caregivers
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A specially designed intervention program involving input from a psychologist and physiotherapist not only improved developmental outcomes at 2 years for preterm infants but diminished depression and anxiety in caregivers as well, according to researchers in Melbourne, Australia.
“Very preterm infants at high risk of abnormal development should commence intervention programs as soon as possible, to take advantage of the increased plasticity of the developing brain,” the researchers wrote. They also noted that addressing the mental well-being of these infants’ parents and guardians is essential because they are at an increased risk for emotional distress. The researchers said, however, that few studies have been conducted in this area.
To evaluate the efficacy of an in-home preventive care program on the physical and cognitive development of preterm infants, the researchers performed a randomized controlled trial using an intervention plan devised by the Victorian Infant Brain Studies (VIBeS) team.
“The intervention aimed to educate the primary caregivers about infant self-regulation and techniques for improving postural stability, coordination, and strength and to support the parents’ mental health and parent-infant relationship throughout the first year,” the researchers wrote. The program was composed of nine 1.5- to 2-hour sessions that took place in families’ homes.
Primary outcomes for the children included cognitive language, motor development at corrected age of 2 years, as denoted by Bayley Scales of Infant and Toddler Development III scores. Behavioral and emotional regulation at corrected age of 2 years was also gauged using the Infant-Toddler Social and Emotional Assessment. For this examination, parents reported on their children’s behavior via questionnaire.
Caregiver outcomes — such as the presence of anxiety or depression — were measured using the Hospital Anxiety and Depression Scale. Parents and guardians answered 14 questions designed to assess the mental health of the respondent.
The researchers reported that 96% of the 120 children analyzed went on to complete the Bayley Scales of Infant and Toddler Development III and 83% underwent testing with the Infant-Toddler Social and Emotional Assessment. Eighty-six percent of caregivers answered the questions contained in the Hospital Anxiety and Depression Scale.
Results indicated that few differences existed between the control and intervention groups in the areas of cognitive, language or motor composite scores, although intervention was linked to a 0.26 SD improvement in cognitive scores. The researchers also did not observe any disparities between the groups when comparing motor, cognitive or language delays.
Children in the intervention group, however, did have better scores for externalizing and dysregulation behaviors as well as higher competence scores. Additionally, data showed that these children were less likely to be at risk for having externalizing, internalizing or dysregulation behaviors when compared with those in the control group (21% vs. 50%; OR=0.26; 95% CI, 0.10-0.70).
Caregivers of children in the intervention group also benefited from the program and generally reported lower levels of anxiety and depression and were less likely to be at risk for either condition.
Spittle AJ. Pediatrics. 2010;126:e171-e178.