Behavioural and cognitive outcomes following an early stress-reduction intervention for very preterm and extremely preterm infants

Background The landmark findings of the Mother–Infant Transaction Program (MITP) showing improved neurodevelopment of preterm infants following parent-sensitivity training delivered in the neonatal intensive care unit have not been consistently replicated. This study evaluated an MITP-type intervent...

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Bibliographic Details
Published in:Pediatric research 2019-07, Vol.86 (1), p.92-99
Main Authors: Milgrom, Jeannette, Martin, Paul R., Newnham, Carol, Holt, Christopher J., Anderson, Peter J., Hunt, Rod W., Reece, John, Ferretti, Carmel, Achenbach, Thomas, Gemmill, Alan W.
Format: Article
Language:English
Subjects:
Clinical Research Article
Intensive care
Intervention
Medicine
Medicine & Public Health
Newborn babies
Pediatric Surgery
Pediatrics
Premature babies
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Summary:Background The landmark findings of the Mother–Infant Transaction Program (MITP) showing improved neurodevelopment of preterm infants following parent-sensitivity training delivered in the neonatal intensive care unit have not been consistently replicated. This study evaluated an MITP-type intervention in terms of neurobehavioural development to preschool age. Methods A randomised controlled trial involved 123 very preterm and extremely preterm infants allocated to either a parent-sensitivity intervention (PremieStart, n  = 60) or to standard care ( n  = 63). When children were 2 and 4.5 years corrected age, parents completed the Child Behavior Checklist (CBCL). General development was assessed at 2 years with the Bayley Scales of Infant Development (Bayley-III). At 4.5 years, cognitive functioning was assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and executive functioning with the NEPSY-II. Results There were no significant between-group differences in behaviour problems at 2 or 4.5 years, general development at 2 years, or cognitive and executive functioning at 4.5 years. Conclusion Advances in the quality of neonatal intensive care may mean that MITP-type interventions now have limited additional impact on preterm infants’ long-term neurobehavioural outcomes. The gestational age of infants and the exact timing of intervention may also affect its efficacy.
ISSN:0031-3998
1530-0447
DOI:10.1038/s41390-019-0385-9