Arch Dis Child Fetal Neonatal Ed 94:F92-F97 doi:10.1136/adc.2008.141002
  • Original article

No change in developmental outcome with incubator covers and nesting for very preterm infants in a randomised controlled trial

  1. C M Maguire1,
  2. F J Walther1,
  3. P H T van Zwieten2,
  4. S Le Cessie3,
  5. J M Wit1,
  6. S Veen1,
  7. On behalf of the Leiden Developmental Care Project
  1. 1
    Department of Pediatrics, Subdivision of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2
    Department of Pediatrics, Subdivision of Neonatology, Haga Hospital, Juliana Children’s Hospital, The Hague, The Netherlands
  3. 3
    Department of Medical Statistics, Leiden University Medical Center, The Netherlands
  1. Dr S Veen, Department of Pediatrics, J-6-S, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; s.veen{at}
  • Accepted 27 July 2008
  • Published Online First 14 August 2008


Objective: To investigate in a randomised controlled trial the effect of basic elements of developmental care (incubator covers and positioning aids) on growth and neurodevelopment in infants born at < 32 weeks.

Method: Infants were randomised within 48 h of birth to a developmental care (DC) or standard care (C) group. Outcome measures at 1 and 2 years corrected age were growth, standardised neurological examinations, and mental (MDI) and psychomotor (PDI) development (Dutch version of the Bayley Scales of Infant Development II).

Results: 192 infants were recruited (DC = 98; C = 94). Thirteen infants (DC = 7, C = 6) were excluded because they were admitted for <5 days or died within the first 5 days. In total, 179 infants met the inclusion criteria. In-hospital mortality was 12/91 (13.2%) in the DC group and 8/88 (9.1%) in the C group. Assessments were carried out on 147 children (DC = 74, C = 73) at 1 year and 142 children (DC = 72, C = 70) at 2 years. No significant difference in growth, neurological outcomes or MDI was found. A positive trend in PDI at 1 year (p = 0.05) did not continue once the children reached 2 years. There was no difference found when neurological and developmental scores were combined.

Conclusions: Basic developmental care has no positive effect on neurological and mental development or growth at 1 and 2 years of age in infants born at <32 weeks. A positive effect on psychomotor development at 1 year did not continue at 2 years of age.

Trial registration number: ISRCTN84995192.


  • Funding: This study was funded by the ZONMW (grant 2100.0072) and the Health Care Efficiency Research Fund LUMC.

  • Competing interests: None.

  • Ethics approval: Obtained.

  • Patient consent: Parental consent obtained.

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