School-age effects of the newborn individualized developmental care and assessment program for preterm infants with intrauterine growth restriction: preliminary findings.
Background: The experience in the newborn intensive care nursery results in premature infants' neurobehavioral and neurophysiological dysfunction and poorer brain structure. Preterms with severe intrauterine growth restriction are doubly jeopardized given their compromised brains. The Newborn Indivi...
| Publicado en: | BMC Pediatrics Vol. 13; no. 1; pp. 25 - 26 |
|---|---|
| Autores principales: | , , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
BioMed Central
2013
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104253082&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104253082 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712431 1CIE jtl: BMC Pediatrics issn: 14712431 maglogo: N pubinfo: dt: 2013 vid: 13 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 104253082 104253082 NLM23421857 2012049194 10.1186/1471-2431-13-25 NLM23421857 PMC3600990 104253082 ppf: 25 ppct: 1 formats: tig: atl: School-age effects of the newborn individualized developmental care and assessment program for preterm infants with intrauterine growth restriction: preliminary findings. aug: au: McAnulty, Gloria Duffy, Frank H Kosta, Sandra Weisenfeld, Neil I Warfield, Simon K Butler, Samantha C Alidoost, Moona Bernstein, Jane Holmes Robertson, Richard Zurakowski, David Als, Heidelise affil: Department of Psychiatry, Neurobehavioral Infant and Child Studies, Enders Pediatric Research Laboratories, EN-107, Children's Hospital Boston, Harvard Medical School, 320 Longwood Avenue, 02115, Boston, MA, USA. gloria.mcanulty@childrens.harvard.edu. sug: subj: Brain Physiology Child Development Mental Processes Fetal Growth Retardation Therapy Infant, Premature Intensive Care, Neonatal Methods Achievement Analysis of Variance Brain Child Child Behavior Cognition Discriminant Analysis Electroencephalography Female Prospective Studies Human Infant Behavior Infant, Newborn Magnetic Resonance Imaging Male Psychological Tests Treatment Outcomes Clinical Trials Child: 6-12 years Infant, Newborn: birth-1 month Female Male ab: Background: The experience in the newborn intensive care nursery results in premature infants' neurobehavioral and neurophysiological dysfunction and poorer brain structure. Preterms with severe intrauterine growth restriction are doubly jeopardized given their compromised brains. The Newborn Individualized Developmental Care and Assessment Program improved outcome at early school-age for preterms with appropriate intrauterine growth. It also showed effectiveness to nine months for preterms with intrauterine growth restriction. The current study tested effectiveness into school-age for preterms with intrauterine growth restriction regarding executive function (EF), electrophysiology (EEG) and neurostructure (MRI).Methods: Twenty-three 9-year-old former growth-restricted preterms, randomized at birth to standard care (14 controls) or to the Newborn Individualized Developmental Care and Assessment Program (9 experimentals) were assessed with standardized measures of cognition, achievement, executive function, electroencephalography, and magnetic resonance imaging. The participating children were comparable to those lost to follow-up, and the controls to the experimentals, in terms of newborn background health and demographics. All outcome measures were corrected for mother's intelligence. Analysis techniques included two-group analysis of variance and stepwise discriminate analysis for the outcome measures, Wilks' lambda and jackknifed classification to ascertain two-group classification success per and across domains; canonical correlation analysis to explore relationships among neuropsychological, electrophysiological and neurostructural domains at school-age, and from the newborn period to school-age.Results: Controls and experimentals were comparable in age at testing, anthropometric and health parameters, and in cognitive and achievement scores. Experimentals scored better in executive function, spectral coherence, and cerebellar volumes. Furthermore, executive function, spectral coherence and brain structural measures discriminated controls from experimentals. Executive function correlated with coherence and brain structure measures, and with newborn-period neurobehavioral assessment.Conclusion: The intervention in the intensive care nursery improved executive function as well as spectral coherence between occipital and frontal as well as parietal regions. The experimentals' cerebella were significantly larger than the controls'. These results, while preliminary, point to the possibility of long-term brain improvement even of intrauterine growth compromised preterms if individualized intervention begins with admission to the NICU and extends throughout transition home. Larger sample replications are required in order to confirm these results.Clinical Trial Registration: The study is registered as a clinical trial. The trial registration number is NCT00914108. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|