University of Queensland Center for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Royal Brisbane and Women's Hospital, Brisbane, Australia.
Queensland Cerebral Palsy and Rehabilitation Research Center, UQ Child Health Research Center, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
J Pediatr. 2019 Jul;210:48-54.e2. doi: 10.1016/j.jpeds.2019.01.024. Epub 2019 Mar 8.
To determine the efficacy of a hospital-based intervention that transitions into existing community support, in enhancing developmental outcomes at 2 years of corrected age in infants born at less than 32 weeks.
In total, 323 families of 384 infants born <32 weeks were randomized to receive intervention or care-as-usual. The intervention teaches parents coping skills, partner support, and effective parenting strategies over 4 hospital-based and 4 home-phone sessions. At 2 years of corrected age maternally reported child behavior was assessed by the Infant and Toddler Social Emotional Adjustment Scale. Observed child behavior was coded with the Revised Family Observation Schedule. Cognitive, language, and motor skills were assessed with the Bayley Scales of Infant and Toddler Development III.
Mean gestational age of infants was 28.5 weeks (SD = 2.1), and mothers' mean age was 30.6 years (SD = 5.8). A total of 162 families (n = 196 infants) were allocated to intervention and 161 families (n = 188 infants) received care-as-usual. There was no significant adjusted difference between treatment groups on dysregulation (0.2; 95% CI -2.5 to 3.0, P = .9) externalizing (0.3; 95% CI -1.6 to 2.2, P = .8), internalizing (-1.5; 95% CI -4.3 to 1.3, P = .3), observed aversive (0.00; -0.04 to 0.04, P = .9), or nonaversive behavior (-0.01; 95% CI -0.05 to 0.03, P = .7). Intervention children scored significantly higher on cognition (3.5; 95% CI 0.2-6.8, P = .04) and motor skill (5.5; 95% CI 2.5-8.4, P < .001), and approached significance on language (3.8; 95% CI -0.3 to 7.9, P = .07).
Baby Triple P for Preterm Infants increases cognitive and motor skills but does not impact behavior. The results are evidence that hospital-based interventions can improve some developmental outcomes for infants <32 weeks.
ACTRN 12612000194864.
确定一项基于医院的干预措施向现有社区支持的转变，是否能提高小于 32 周出生的婴儿在 2 岁时的发育结果。
共有 384 名出生时<32 周的 323 名婴儿的家庭被随机分配接受干预或常规护理。该干预措施通过 4 次医院和 4 次家庭电话会议向父母传授应对技能、伴侣支持和有效的育儿策略。在 2 岁时，通过婴儿和幼儿社会情感适应量表（Infant and Toddler Social Emotional Adjustment Scale）评估母亲报告的儿童行为。使用修订后的家庭观察时间表（Revised Family Observation Schedule）对儿童行为进行编码。使用贝利婴幼儿发育量表第三版（Bayley Scales of Infant and Toddler Development III）评估认知、语言和运动技能。
婴儿的平均胎龄为 28.5 周（标准差=2.1），母亲的平均年龄为 30.6 岁（标准差=5.8）。共有 162 个家庭（n=196 名婴儿）被分配到干预组，161 个家庭（n=188 名婴儿）接受常规护理。治疗组之间在失调（0.2；95%置信区间-2.5 至 3.0，P=0.9）、外化（0.3；95%置信区间-1.6 至 2.2，P=0.8）、内化（-1.5；95%置信区间-4.3 至 1.3，P=0.3）、观察到的厌恶行为（0.00；-0.04 至 0.04，P=0.9）或非厌恶行为（-0.01；95%置信区间-0.05 至 0.03，P=0.7）方面均无显著的调整差异。干预组的儿童在认知（3.5；95%置信区间 0.2-6.8，P=0.04）和运动技能（5.5；95%置信区间 2.5-8.4，P<0.001）方面的得分显著更高，在语言方面也接近显著（3.8；95%置信区间-0.3 至 7.9，P=0.07）。
针对早产儿的婴儿 Triple P 增加了认知和运动技能，但对行为没有影响。这些结果表明，基于医院的干预措施可以改善小于 32 周的婴儿的一些发育结果。
ACTRN12612000194864。
