Johnson Samantha, Whitelaw Andrew, Glazebrook Cris, Israel Chrissie, Turner Rebecca, White Ian R, Croudace Tim, Davenport Franca, Marlow Neil
University of Nottingham, Nottingham, United Kingdom.
J Pediatr. 2009 Oct;155(4):488-94. doi: 10.1016/j.jpeds.2009.04.013.
To determine the efficacy of a neonatal parenting intervention for improving development in very preterm infants.
A cluster-randomized, controlled trial with a cross-over design and washout period was conducted in 6 neonatal centers. Two hundred thirty-three babies <32 weeks' gestation were recruited (intervention = 112; control = 121). Intervention families received weekly Parent Baby Interaction Programme (PBIP) sessions during neonatal intensive care unit admission and up to 6 weeks after discharge. Control families received standard care. All 195 infants remaining in the study at 24 months' corrected age were assessed by psychologists blinded to group allocation.
There was no significant difference in Mental Development Index (-0.9 points; 95% CI, -5.0, 3.2) or Psychomotor Development Index (2.5; -3.3, 8.4) scores between the intervention and control groups and no significant effect of intervention on Mental Development Index or Psychomotor Development Index scores for subgroups dichotomized by gestational age (<28 weeks/> or =28 weeks), parity (1st/other child) or mother's cohabiting status (supported/unsupported).
There was no effect of PBIP on infant development at 2 years' corrected age. Parenting interventions may be better delivered after discharge or targeted for preterm infants with high biological and social risk.
确定一项新生儿育儿干预措施对改善极早产儿发育的效果。
在6个新生儿中心进行了一项采用交叉设计和洗脱期的整群随机对照试验。招募了233名孕周<32周的婴儿(干预组=112名;对照组=121名)。干预组家庭在新生儿重症监护病房住院期间以及出院后长达6周内每周接受亲子互动项目(PBIP)课程。对照组家庭接受标准护理。所有在矫正年龄24个月时仍留在研究中的195名婴儿由对分组情况不知情的心理学家进行评估。
干预组和对照组在心理发展指数(-0.9分;95%可信区间,-5.0,3.2)或心理运动发展指数(2.5;-3.3,8.4)得分上没有显著差异,并且对于按孕周(<28周/>或=28周)、胎次(第一胎/其他孩子)或母亲同居状况(有支持/无支持)二分的亚组,干预对心理发展指数或心理运动发展指数得分没有显著影响。
在矫正年龄2岁时,PBIP对婴儿发育没有影响。育儿干预措施可能在出院后实施效果更好,或者针对具有高生物学和社会风险的早产儿。