Individualized developmental care in a Dutch NICU: short-term clinical outcome

Aim: To compare the short‐term clinical outcomes of Newborn Individualized Developmental Care and Assessment Program (NIDCAP®) and conventional care. Methods: A prospective phase‐lag cohort study was performed in a Dutch tertiary level neonatal intensive care unit (NICU). Infants born before 30 week...

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Bibliographic Details
Published in:Acta Paediatrica 2007-10, Vol.96 (10), p.1409-1415
Main Authors: Wielenga, JM, Smit, BJ, Merkus, MP, Kok, JH
Format: Article
Language:English
Subjects:
Biological and medical sciences
Developmental care
Female
General aspects
Gestational Age
Health Status Indicators
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Length of Stay
Male
Medical sciences
Neonatal intensive care unit
Netherlands
Outcome
Premature infant
Program Evaluation
Prospective Studies
Risk Factors
Time Factors
Treatment Outcome
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Summary:Aim: To compare the short‐term clinical outcomes of Newborn Individualized Developmental Care and Assessment Program (NIDCAP®) and conventional care. Methods: A prospective phase‐lag cohort study was performed in a Dutch tertiary level neonatal intensive care unit (NICU). Infants born before 30 weeks of gestational age (GA) were included, 26 in the conventional and 25 in the NIDCAP group. Outcomes were respiratory status, cerebral ultrasound findings, growth and length of NICU stay. Results: At study entry, NIDCAP infants had a lower birth weight (mean [SD]: 1043 [191] vs. 1154 [174] g, p = 0.044), were more often small for GA (8 vs. 2, p = 0.038), had smaller head circumferences (mean [SD]: 25.1 [1.3] vs. 26.1 [1.8] cm, p = 0.041) and were less often multiples (6 vs. 14, p = 0.029) than conventional care infants. During NICU stay, more infants in the NIDCAP group developed pneumonia (9 vs. 3, p = 0.040) due to nosocomial infections. After adjustment for these differences, a decreased risk for more severe cerebral damage in favour of NIDCAP was seen (Odds ratio: 0.12, 95% CI: 0.03–0.46, p = 0.002). No differences were observed for the other outcomes. Conclusions: We conclude with precaution that in this phase‐lag cohort study NIDCAP may have resulted in less severe cerebral damage, but was not associated with other clinical outcomes. In light of these findings, NIDCAP deserves further exploration.
ISSN:0803-5253
1651-2227
DOI:10.1111/j.1651-2227.2007.00451.x