Department of Clinical & Health Psychology, Austin Health, Victoria, Australia.
Pediatr Res. 2010 Mar;67(3):330-5. doi: 10.1203/PDR.0b013e3181cb8e2f.
After birth, preterm infants face a stressful environment, which may negatively impact early brain development and subsequent neurobehavioral outcomes. This randomized controlled trial involving 45 women with infants <30-wk gestation, assessed the effectiveness of training parents in reducing stressful experiences. Intervention consisted of 10 sessions in the Neonatal Intensive Care Unit (NICU). Postintervention, at term-equivalent (40-wk postmenstrual age), magnetic resonance imaging (MRI) was performed to evaluate brain structure and development. Quantitative volumetric techniques were used to estimate overall and regional brain volumes for different tissue types including CSF, CGM, DNGM, UWM, and MWM. DTI was used to evaluate the integrity and maturation of white matter by ADC and FA. Maturation and connectivity of white matter, characterized by diffusion MR measures of ADC and FA, were significantly enhanced in the intervention group, who displayed greater restriction in ADC and increase in FA. There were no significant effects on either brain volumes or on short-term medical outcomes. Thus, sensitivity training for parents in the NICU is associated with improved cerebral white matter micro-structural development in preterm infants.
婴儿出生后,会面临充满压力的环境,这可能会对其早期大脑发育和随后的神经行为结果产生负面影响。本项随机对照试验纳入了 45 名胎龄<30 周的产妇,评估了对其进行父母培训以减少压力体验的有效性。干预措施包括在新生儿重症监护病房(NICU)进行 10 次课程。干预后,在相当于足月(40 周龄)时,进行磁共振成像(MRI)以评估大脑结构和发育。使用定量容积技术来估计包括 CSF、CGM、DNGM、UWM 和 MWM 在内的不同组织类型的整体和区域脑容量。使用 DTI 通过 ADC 和 FA 评估白质的完整性和成熟度。干预组的白质成熟和连接性得到了显著增强,表现为 ADC 受限增加和 FA 增加。脑容量或短期医疗结果均无显著影响。因此,NICU 中对父母进行敏感性训练与早产儿大脑白质微观结构发育的改善有关。