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针对低体重早产儿的婴儿健康与发展项目:项目内容、家庭参与情况及儿童智力

Infant Health and Development Program for low birth weight, premature infants: program elements, family participation, and child intelligence.

作者信息

Ramey C T, Bryant D M, Wasik B H, Sparling J J, Fendt K H, LaVange L M

机构信息

Civitan International Research Center, Birmingham, AL 35294.

出版信息

Pediatrics. 1992 Mar;89(3):454-65.

PMID:1371341
Abstract

The Infant Health and Development Program was an eight-site randomized controlled trial testing the efficacy of early intervention to enhance the cognitive, behavioral, and health status of low birth weight, premature infants. The 377 intervention families received for the first 3 years of life: (1) pediatric follow-up, (2) home visits, (3) parent support groups, and (4) a systematic educational program provided in specialized child development centers. The control group (n = 608) received the same pediatric follow-up and referral services only. This paper describes the delivery of the intervention and its outcomes. A Family Participation Index that was the sum of participation frequencies in each of the program modalities unique to the intervention revealed that program implementation was not different across the eight sites. Index scores did not vary systematically with mother's ethnicity, age, or education or with child's birth weight, gender, or neonatal health status; but they were positively related to children's IQ scores at age 3. Only 1.9% of children of families in the highest tercile of participation scored in the mentally retarded range (IQ less than or equal to 70), whereas 3.5% and 13% of children in the middle and lowest participation terciles, respectively, scored in the retarded range. Similar findings were obtained for borderline intellectual functioning. These findings are consistent with previous research linking intensity of intervention services with degree of positive cognitive outcomes for high-risk infants. The determinants of variations in individual family participation remain unknown.

摘要

婴儿健康与发展项目是一项在八个地点开展的随机对照试验,旨在测试早期干预对提高低出生体重早产儿的认知、行为和健康状况的效果。377个干预家庭在孩子出生后的前三年接受了以下服务:(1)儿科随访;(2)家访;(3)家长支持小组;(4)在专门的儿童发展中心提供的系统教育项目。对照组(n = 608)仅接受相同的儿科随访和转诊服务。本文描述了干预措施的实施情况及其结果。一个家庭参与指数是干预措施特有的每个项目模式参与频率的总和,该指数显示八个地点的项目实施情况没有差异。指数得分并未随母亲的种族、年龄或教育程度,或孩子的出生体重、性别或新生儿健康状况而系统变化;但它们与孩子3岁时的智商得分呈正相关。参与度最高三分位数家庭的孩子中,只有1.9%的智商得分在智力迟钝范围内(智商小于或等于70),而参与度处于中间和最低三分位数的孩子中,分别有3.5%和1

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