Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; and Department of Psychology, National Cheng Kung University, Tainan, Taiwan.
Institute of Physical Therapy, College of Medicine, National Taiwan University; and Department of Physical Medicine and Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
Phys Ther. 2019 Dec 16;99(12):1690-1702. doi: 10.1093/ptj/pzz120.
Family-centered intervention for preterm infants has shown short- to medium-term developmental benefits; however, the neurological effects of intervention have rarely been explored.
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.
This was a multicenter, single-blind randomized controlled trial.
The study took place in 3 medical centers in northern and southern Taiwan.
Two hundred fifty-one preterm infants with VLBW were included.
The FCIP group received a family-centered intervention and the UCP group received standard care during hospitalization.
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.
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).
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.
Family-centered intervention facilitates short-term neurophysiological maturation in preterm infants with VLBW in Taiwan.
以家庭为中心的早产儿干预已显示出短期至中期的发育益处；然而，干预对神经的影响很少被探索。
本研究的目的是在台湾，检查以家庭为中心的干预方案（FCIP）对极低出生体重（VLBW；出生体重<1500 克）早产儿神经生理功能的影响，比较 FCIP 与常规护理方案（UCP）的效果，并探讨 FCIP 对神经行为和神经生理功能的影响。
这是一项多中心、单盲随机对照试验。
研究在台湾北部和南部的 3 家医疗中心进行。
251 名极低出生体重的早产儿纳入研究。
FCIP 组接受以家庭为中心的干预，UCP 组在住院期间接受标准护理。
采用新生儿神经行为检查中文版评估婴儿的神经行为表现，采用睡眠时和新生儿期听觉Oddball 任务时的脑电图/事件相关电位评估其神经生理功能。
与 UCP 相比，FCIP 促进了更成熟的神经生理功能，包括在Oddball 任务中所有婴儿左额区负性平均振幅更大、小胎龄儿睡眠时半球间前额-中央相干性更低、胎龄适宜儿睡眠时半球间额部相干性更高。此外，胎龄适宜儿的半球间相干性与总神经行为评分呈正相关（r=0.20）。
FCIP 组比 UCP 组更多地使用了父母依从性策略，这可能有利于该研究的干预效果。
以家庭为中心的干预有助于促进台湾极低出生体重早产儿的短期神经生理成熟。
