Fontana Camilla, De Carli Agnese, Ricci Daniela, Dessimone Francesca, Passera Sofia, Pesenti Nicola, Bonzini Matteo, Bassi Laura, Squarcina Letizia, Cinnante Claudia, Mosca Fabio, Fumagalli Monica
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.
Front Pediatr. 2020 Jun 4;8:291. doi: 10.3389/fped.2020.00291. eCollection 2020.
To determine the effectiveness of an early intervention program in enhancing visual function in very preterm infants. Methods: We conducted a RCT. We included preterm infants born between 25 and 29 weeks of gestational age (GA), without severe morbidities, and their families. Infants were randomized to either receive Standard Care (SC) or Early Intervention (EI). SC, according to NICU protocols, included Kangaroo Mother Care and minimal handling. EI included, in addition to routine care, parental training according to the PremieStart program, and multisensory stimulation (infant massage and visual interaction) performed by parents. Visual function was assessed at term equivalent age (TEA) using a prevalidated battery evaluating ocular spontaneous motility, ability to fix and follow a target, reaction to color, stripes discrimination and visual attention at distance. Seventy preterm (EI = 34, SC = 36) infants were enrolled. Thirteen were excluded according to protocol. Fifty-seven infants (EI = 27, SC = 30) were assessed at TEA. The two groups were comparable for parental and infant characteristics. In total, 59% of infants in the EI group achieved the highest score in all the nine assessed items compared to 17% in the SC group ( = 0.001): all infants in both groups showed complete maturation in four items, but EI infants showed more mature findings in the other five items (ocular motility both spontaneous and with target, tracking arc, stripes discrimination and attention at distance). Our results suggest that EI has a positive effect on visual function maturation in preterm infants at TEA. clinicalTrial.gov (NCT02983513).
确定一项早期干预计划对提高极早产儿视觉功能的有效性。方法:我们进行了一项随机对照试验。纳入孕周在25至29周之间、无严重疾病的早产儿及其家庭。将婴儿随机分为接受标准护理(SC)组或早期干预(EI)组。根据新生儿重症监护病房方案,标准护理包括袋鼠式护理和尽量减少操作。早期干预除常规护理外,还包括根据PremieStart计划进行的家长培训,以及家长进行的多感官刺激(婴儿按摩和视觉互动)。在足月等效年龄(TEA)时,使用经过预验证的一组测试评估视觉功能,这些测试评估眼球自发运动、注视和追踪目标的能力、对颜色的反应、条纹辨别和远距离视觉注意力。共纳入70名早产儿(EI组 = 34名,SC组 = 36名)。根据方案排除13名。57名婴儿(EI组 = 27名,SC组 = 30名)在足月等效年龄时接受了评估。两组在家长和婴儿特征方面具有可比性。总体而言,EI组59%的婴儿在所有九项评估项目中获得最高分,而SC组为17%(P = 0.001):两组所有婴儿在四项项目中均显示完全成熟,但EI组婴儿在其他五项项目(自发和有目标时的眼球运动、追踪弧度、条纹辨别和远距离注意力)中表现出更成熟的结果。我们的结果表明,早期干预对足月等效年龄的早产儿视觉功能成熟有积极影响。ClinicalTrials.gov(NCT02983513)。