Family-Centered Care Enhanced Neonatal Neurophysiological Function in Preterm Infants: Randomized Controlled Trial.

BACKGROUND

Family-centered intervention for preterm infants has shown short- to medium-term developmental benefits; however, the neurological effects of intervention have rarely been explored.

OBJECTIVE

The objectives of this study were to examine the effect of a family-centered intervention program (FCIP) on neurophysiological functions in preterm infants with very low birth weight (VLBW; birth weight of < 1500 g) in Taiwan, to compare the effect of the FCIP with that of a usual-care program (UCP), and to explore the FCIP-induced changes in neurobehavioral and neurophysiological functions.

DESIGN

This was a multicenter, single-blind randomized controlled trial.

SETTING

The study took place in 3 medical centers in northern and southern Taiwan.

PARTICIPANTS

Two hundred fifty-one preterm infants with VLBW were included.

INTERVENTION

The FCIP group received a family-centered intervention and the UCP group received standard care during hospitalization.

MEASUREMENTS

Infants were assessed in terms of neurobehavioral performance using the Neonatal Neurobehavioral Examination-Chinese version, and their neurophysiological function was assessed using electroencephalography/event-related potentials during sleep and during an auditory oddball task during the neonatal period.

RESULTS

The FCIP promoted more mature neurophysiological function than the UCP, including greater negative mean amplitudes of mismatch negativities in the left frontal region in the oddball task in all infants, lower intrahemispheric prefrontal-central coherence during sleep in infants who were small for gestational age, and higher interhemispheric frontal coherence during sleep in those who were appropriate for gestational age. Furthermore, interhemispheric coherence was positively associated with the total neurobehavioral score in preterm infants who were appropriate for gestational age (r = 0.20).

LIMITATIONS

The fact that more parental adherence strategies were used in the FCIP group than in the UCP group might have favored the intervention effect in this study.

CONCLUSIONS

Family-centered intervention facilitates short-term neurophysiological maturation in preterm infants with VLBW in Taiwan.