Ohgi S, Fukuda M, Akiyama T, Gima H
School of Rehabilitation Sciences, Seirei Christopher College, Shizuoka, Japan.
J Paediatr Child Health. 2004 Dec;40(12):689-95. doi: 10.1111/j.1440-1754.2004.00512.x.
To determine the effect of an early intervention programme (EIP) on low birthweight infants with cerebral injuries.
Subjects were 23 high-risk low birthweight infants (periventricular leukomalacia 15, intraventricular haemorrhage 5, both 3) receiving care in the neonatal intensive care unit (NICU) at Nagasaki University Hospital. Subjects were randomly assigned to the EIP group (n = 12) or the control group (n = 11). Participants in the EIP group received a Neonatal Behavioral Assessment scale (NBAS)-based intervention combined with developmental support designed to enhance the infants' development and the quality of the parent-infant relationship. The control group received routine medical nursing care without the EIP. The EIP began prior to discharge from the NICU and lasted until 6 months of corrected age. All children were examined on the NBAS preintervention and again at 44 weeks postconceptional age. Maternal anxiety status (STAI) and maternal feelings of confidence in dealing with her baby (LCC) were measured pre and postintervention. Mental and motor development was assessed postintervention using the Bayley Scale of Infant Development.
Orientation and State Regulation of infant behavioural profiles, the STAI and LCC scores significantly improved in the EIP group (mean difference (95% CI): Orientation 0.7 (0.4, 1.1), State Regulation 0.9 (0.3, 1.5), STAI -5.5 (- 9.1, -1.9, LCC 5.3 (4.2, 6.5)), but not in the control group. Bayley mental developmental index (MDI) score in the EIP group was higher than in the control group, but there was no significant difference between the two groups (mean difference (95% CI): MDI 8.5 (- 0.8, 17.8), PDI 6.7 (- 1.9, 15.4)).
The EIP has beneficial effects on neonatal neurobehavioural development and maternal mental health of low birthweight infants with cerebral injuries. This evidence suggests that short-term changes in maternal mental health and infant neurobehaviour promoted by an EIP may serve to initiate a positive interaction between parents and infants.
确定早期干预方案（EIP）对脑损伤低出生体重儿的影响。
研究对象为23名在长崎大学医院新生儿重症监护病房（NICU）接受治疗的高危低出生体重儿（脑室周围白质软化症15例，脑室内出血5例，两者皆有的3例）。将研究对象随机分为EIP组（n = 12）和对照组（n = 11）。EIP组的参与者接受基于新生儿行为评估量表（NBAS）的干预，并结合旨在促进婴儿发育和改善母婴关系质量的发育支持。对照组接受常规医疗护理，不进行EIP。EIP在患儿从NICU出院前开始，持续至矫正年龄6个月。所有儿童在干预前接受NBAS检查，并在孕龄44周时再次检查。在干预前后测量母亲的焦虑状态（状态特质焦虑问卷，STAI）和母亲应对婴儿的信心感受（LCC）。干预后使用贝利婴儿发育量表评估智力和运动发育情况。
EIP组婴儿行为特征的定向和状态调节、STAI和LCC评分显著改善（平均差值（95%置信区间）：定向0.7（0.4，1.1），状态调节0.9（0.3，1.5），STAI -5.5（-9.1，-1.9），LCC 5.3（4.2，6.5）），而对照组无改善。EIP组的贝利智力发育指数（MDI）评分高于对照组，但两组间无显著差异（平均差值（95%置信区间）：MDI 8.5（-0.8，17.8），PDI 6.7（-1.9，15.4））。
EIP对脑损伤低出生体重儿的新生儿神经行为发育和母亲心理健康有有益影响。这一证据表明，EIP促进的母亲心理健康和婴儿神经行为的短期变化可能有助于启动父母与婴儿之间的积极互动。
