Effect of Developmental Care on Preterm Neonates’ Neurodevelopmental Outcomes at 12 Months of Age

Document Type : Original Article

Authors

1 Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

2 Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Pediatric Health Research Center of Tabriz, Tabriz University of Medical Sciences, Tabriz, Iran

4 Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

5 Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran

6 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Background: Premature birth and subsequent admission to the neonatal intensive care unit (NICU) may impair the neurodevelopment of neonates. The present study aimed to determine the effect of developmental care on neurodevelopmental outcomes of newborns.
Methods: This quasi-experimental study was conducted on 105 premature neonates (in three groups of 35 newborns). The control group received conventional care, and the intervention group 1 received developmental care beginning since admission to NICU stay. In addition, the intervention group 2 received developmental care since entering the delivery or operating room. The developmental outcomes were evaluated based on the Ages and Stages Questionnaire (ASQ) and Bayley-III Scales of Infant and Toddler Development. Moreover, magnetic resonance imaging was performed to evaluate the brain myelination at the adjusted age of 12 months.
Results: The obtained findings showed that the frequency rates of communication and language impairment were significantly lower in the intervention group 2, compared to those reported for the control group and intervention group 1, based on the ASQ. The comparison of the scores of the Bayley subscales (i.e., cognition, language, and motor) showed that the frequency of language impairment was significantly higher in the control group, compared to those reported for the intervention group 1 (P=0.012) and intervention group 2 (P=0.024). No significant difference was observed in terms of the neonates’ brain myelination (P>0.05).
Conclusion: The obtained results showed that developmental care, especially when initiated since birth, may improve some aspects of developmental outcomes in preterm newborns.

Keywords


 
1. Maguire CM, Walther FJ, Sprij AJ, Le Cessie S, Wit JM, Veen S, et al. Effects of individualized developmental care in a randomized trial of preterm infants 2. Volpe JJ. Neurology of the newborn e-book. New York: Elsevier Health Sciences; 2008.
3. Smith GC, Gutovich J, Smyser C, Pineda R, Newnham C, Tjoeng TH, et al. Neonatal intensive care unit stress is associated with brain development in preterm infants. Ann Neurol. 2011; 70(4):541-9.
4. Martin RJ, Fanaroff AA, Walsh MC. Fanaroff and Martin's neonatal-perinatal medicine e-book: diseases of the fetus and infant. New York: Elsevier Health Sciences; 2010.
5. Khan Z. Individualised developmental supportive care in the NICU. J Neonatal Nurs. 2003; 9(5):161-4.
6. Vandenberg KA. Individualized developmental care for high risk newborns in the NICU: a practice guideline. Early Hum Dev. 2007; 83(7):433-42.
7. Bastani F, Rajai N, Amini E, Haghani H, Janmohammadi S. The assessment of sleep and wake state of premature infants hospitalized in neonatal intensive care unit (NICU) and itś relation with demographic variables. Alborz Univ Med J.
2013; 2(1):1-6.
8. Als H, McAnulty GB. The newborn individualized developmental care and assessment program (NIDCAP) with kangaroo mother care (KMC): comprehensive care for preterm infants. Curr Womens Health Rev. 2011; 7(3):288-301.
9. Als H. A synactive model of neonatal behavioral organization: framework for the assessment of neurobehavioral development in the premature infant and for support of infants and parents in the neonatal intensive care environment. Phys Occup Ther Pediatr. 1986; 6(3-4):3-53.
10. Maguire CM, Veen S, Sprij AJ, Le Cessie S, Wit JM, Walther FJ, et al. Effects of basic developmental care on neonatal morbidity, neuromotor development, and growth at term age of infants who were born at 11. Moore T, Hennessy EM, Myles J, Johnson SJ, Draper ES, Costeloe KL, et al. Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies. BMJ. 2012; 345:e7961.
12. Sehgal A, Stack J. Developmentally supportive care and NIDCAP. Indian J Pediatr. 2006; 73(11):1007-10.
13. Kanagasabai PS, Mohan D, Lewis LE, Kamath A, Rao BK. Effect of multisensory stimulation on neuromotor development in preterm infants. Indian J Pediatr. 2013; 80(6):460-4.
14. Mirghafourvand M, Ouladsahebmadarek E, Hosseini M, Heidarabadi S, Asghari jafarabadi M, Hasanpour S. The effect of creating opportunities for parent empowerment program on parent's mental health: a systematic review. Iran J Pediatr. 2017; 27(2):e570.
15. Coughlin M, Gibbins S, Hoath S. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice. J Adv Nurs. 2009; 65(10):2239-48.
16. Als H. NIDCAP: testing the effectiveness of a relationship-based comprehensive intervention. Pediatrics. 2009; 124(4):1208-10.
17. Sizun J, Westrup B. Early developmental care for preterm neonates: a call for more research. Arch Dis Child Fetal Neonatal Ed. 2004; 89(5):F384-8.
18. Montirosso R, Del Prete A, Bellù R, Tronick E, Borgatti R. Level of NICU quality of developmental care and neurobehavioral performance in very preterm infants. Pediatrics. 2012; 129(5):e1129-37.
19. Als H, Duffy FH, McAnulty G, Butler SC, Lightbody L, Kosta S, et al. NIDCAP improves brain function and structure in preterm infants with severe intrauterine growth restriction. J Perinatol. 2012; 32(10):797-803.
20. Kiechl-Kohlendorfer U, Merkle U, Deufert D, Neubauer V, Peglow UP, Griesmaier E. Effect of developmental care for very premature infants on neurodevelopmental outcome at 2 years of age. Infant Behav Dev. 2015; 39:166-72.
21. Wielenga JM, Smit BJ, Merkus MP, Kok JH. Individualized developmental care in a Dutch NICU: short‐term clinical outcome. Acta Paediatr. 2007;
96(10):1409-15.
22. Peters KL, Rosychuk RJ, Hendson L, Coté JJ, McPherson C, Tyebkhan JM. Improvement of short-and long-term outcomes for very low birth weight infants: Edmonton NIDCAP trial. Pediatrics. 2009; 124(4):1009-20.
23. McAnulty G, Duffy FH, Kosta S, Weisenfeld NI, Warfield SK, Butler SC, et al. School age effects of the newborn individualized developmental care and assessment program for medically low-risk preterm infants: preliminary findings. J Clin Neonatol. 2012; 1(4):184-94.
24. Jacobs SE, Sokol J, Ohlsson A. The newborn individualized developmental care and assessment program is not supported by meta-analyses of the data. J Pediatr. 2002; 140(6):699-706.
25. Ohlsson A. NIDCAP: new controversial evidence for its effectiveness. Pediatrics. 2009; 124(4):1213-5.
26. Hasanpour S, Ouladsahebmadarek E, Hosseini MB, Mirghafourvand M, Heidarabadi S, Jafarabadi MA. The effects of developmental care on short-term outcomes of preterm infants: a quasi-experimental study. Iran Red Crescent Med J. 2017; 19(9):e13799.
27. Vameghi R, Sajedi F, Mojembari AK, Habiollahi A, Lornezhad HR, Delavar B. Cross-cultural adaptation, validation and standardization of Ages and Stages Questionnaire (ASQ) in Iranian children. Iran J Public Health. 2013; 42(5):522.
28. Upadhyay A, Gothwal S, Parihar R, Garg A, Gupta A, Chawla D, et al. Effect of umbilical cord milking in term and near term infants: randomized control
trial. Am J Obstet Gynecol. 2013; 208(2):120.e1-6.
29. Yang MB, Donovan EF, Wagge JR. Race, gender, and clinical risk index for babies (CRIB) score as predictors of severe retinopathy of prematurity. J AAPOS. 2006; 10(3):253-61.
30. Azari N, Soleimani F, Vameghi R, Sajedi F, Shahshahani S, Karimi H, et al. A psychometric study of the Bayley scales of infant and toddler development in Persian language children. Iran J Child Neurol. 2017; 11(1):50-56.
31. Kleberg A, Westrup B, Stjernqvist K. Developmental outcome, child behaviour and mother–child interaction at 3 years of age following Newborn Individualized Developmental Care and Intervention Program (NIDCAP) intervention. Early Hum Dev. 2000; 60(2):123-35.
32. Als H, Lawhon G, Duffy FH, McAnulty GB, Gibes-Grossman R, Blickman JG. Individualized developmental care for the very low-birth-weight preterm infant: medical and neurofunctional effects. JAMA. 1994; 272(11):853-8.
33. Feldman R, Rosenthal Z, Eidelman AI. Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biol Psychiatry. 2014; 75(1):56-64.
34. Almadhoob A, Ohlsson A. Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants. Cochrane Database Syst Rev. 2015; 1:CD010333.