Spittle Alicia J, Barton Sarah, Treyvaud Karli, Molloy Carly S, Doyle Lex W, Anderson Peter J
Victorian Infant Brain Study, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia;
Departments of Physiotherapy.
Pediatrics. 2016 Dec;138(6). doi: 10.1542/peds.2016-1363. Epub 2016 Nov 22.
To examine the child and parental outcomes at school age of a randomized controlled trial of a home-based early preventative care program for infants born very preterm and their caregivers.
At term-equivalent age, 120 infants born at a gestational age of <30 weeks were randomly allocated to intervention (n = 61) or standard care (n = 59) groups. The intervention included 9 home visits over the first year of life focusing on infant development, parental mental health, and the parent-infant relationship. At 8 years' corrected age, children's cognitive, behavioral, and motor functioning and parental mental health were assessed. Analysis was by intention to treat.
One hundred children, including 13 sets of twins, attended follow-up (85% follow-up of survivors). Children in the intervention group were less likely to have mathematics difficulties (odds ratio, 0.42; 95% confidence interval [CI], 0.18 to 0.98; P = .045) than children in the standard care group, but there was no evidence of an effect on other developmental outcomes. Parents in the intervention group reported fewer symptoms of depression (mean difference, -2.7; 95% CI, -4.0 to -1.4; P < .001) and had reduced odds for mild to severe depression (odds ratio, 0.14; 95% CI, 0.03 to 0.68; P = .0152) than parents in the standard care group.
An early preventive care program for very preterm infants and their parents had minimal long-term effects on child neurodevelopmental outcomes at the 8-year follow-up, whereas primary caregivers in the intervention group reported less depression.
研究一项针对极早产儿及其照顾者的家庭早期预防护理项目随机对照试验在学龄期的儿童及家长结局。
在足月相当年龄时，将120名孕周小于30周出生的婴儿随机分配至干预组（n = 61）或标准护理组（n = 59）。干预措施包括在生命的第一年进行9次家访，重点关注婴儿发育、家长心理健康及亲子关系。在矫正年龄8岁时，评估儿童的认知、行为和运动功能以及家长的心理健康。分析采用意向性分析。
100名儿童（包括13对双胞胎）参加了随访（幸存者随访率85%）。与标准护理组儿童相比，干预组儿童出现数学困难的可能性较小（优势比，0.42；95%置信区间[CI]，0.18至0.98；P = 0.045），但没有证据表明对其他发育结局有影响。与标准护理组家长相比，干预组家长报告的抑郁症状较少（平均差异，-2.7；95% CI，-4.0至-1.4；P < 0.001），且轻度至重度抑郁的几率降低（优势比，0.14；95% CI，0.03至0.68；P = 0.0152）。
一项针对极早产儿及其家长的早期预防护理项目在8年随访时对儿童神经发育结局的长期影响极小，而干预组的主要照顾者报告的抑郁较少。
