Graduate School of Life Sciences, Utrecht University, Utrecht, The Netherlands.
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
Pediatr Res. 2022 Jul;92(1):47-60. doi: 10.1038/s41390-021-01718-w. Epub 2021 Sep 10.
Infants born preterm are known to be at risk for abnormal brain development and adverse neurobehavioral outcomes. To improve early neurodevelopment, several non-pharmacological interventions have been developed and implemented in the neonatal intensive care unit (NICU). Sensory-based interventions seem to improve short-term neurodevelopmental outcomes in the inherently stressful NICU environment. However, how this type of intervention affects brain development in the preterm population remains unclear.
A systematic review of the literature was conducted for published studies in the past 20 years reporting the effects of early, non-pharmacological, sensory-based interventions on the neonatal brain after preterm birth.
Twelve randomized controlled trials (RCT) reporting short-term effects of auditory, tactile, and multisensory interventions were included after the screening of 1202 articles. Large heterogeneity was identified among studies in relation to both types of intervention and outcomes. Three areas of focus for sensory interventions were identified: auditory-based, tactile-based, and multisensory interventions.
Diversity in interventions and outcome measures challenges the possibility to perform an integrative synthesis of results and to translate these for evidence-based clinical practice. This review identifies gaps in the literature and methodological challenges for the implementation of RCTs of sensory interventions in the NICU.
This paper represents the first systematic review to investigate the effect of non-pharmacological, sensory-based interventions in the NICU on neonatal brain development. Although reviewed RCTs present evidence on the impact of such interventions on the neonatal brain following preterm birth, it is not yet possible to formulate clear guidelines for clinical practice. This review integrates existing literature on the effect of sensory-based interventions on the brain after preterm birth and identifies methodological challenges for the conduction of high-quality RCTs.
众所周知，早产儿存在脑发育异常和神经行为不良结局的风险。为了改善早期神经发育，已经在新生儿重症监护病房（NICU）中开发并实施了几种非药物干预措施。基于感觉的干预措施似乎可以改善 NICU 环境中固有压力下的短期神经发育结局。然而，这种类型的干预措施如何影响早产儿的大脑发育尚不清楚。
对过去 20 年中发表的有关报告早产儿出生后早期非药物性基于感觉的干预措施对新生儿大脑影响的文献进行了系统回顾。
在筛选了 1202 篇文章后，纳入了 12 项报告听觉、触觉和多感觉干预短期效果的随机对照试验（RCT）。研究在干预类型和结果方面存在很大的异质性。确定了基于感觉的干预措施的三个重点领域：听觉为基础的、触觉为基础的和多感觉干预。
干预措施和结果测量的多样性使得对结果进行综合综合分析以及将其转化为基于证据的临床实践变得具有挑战性。本综述确定了文献中的空白和在 NICU 中实施基于感觉的 RCT 面临的方法学挑战。
本文是第一篇系统综述，旨在调查 NICU 中非药物性、基于感觉的干预措施对新生儿大脑发育的影响。尽管综述的 RCT 提供了此类干预措施对早产儿出生后大脑影响的证据，但目前还不可能为临床实践制定明确的指南。本综述整合了关于基于感觉的干预措施对早产儿出生后大脑影响的现有文献，并确定了进行高质量 RCT 的方法学挑战。
