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NIDCAP in preterm infants and the neurodevelopmental effect in the first 2 years
  1. L Fazilleau1,2,
  2. J J Parienti2,3,
  3. A Bellot1,
  4. B Guillois1,2
  1. 1Department of Neonatology, CHU de Caen, Caen, France
  2. 2University of Caen Basse-Normandie, Medical school, Caen, France
  3. 3Department of Biostatistics and Clinical Research, CHU de Caen, Caen, France
  1. Correspondence to Dr Laura Fazilleau, Division of Neonatology, Department of Woman and Child, University Hospital Côte de Nacre, Avenue Côte de Nacre, Caen 14000, France; fazilleau-l{at}chu-caen.fr

Abstract

Background The Newborn Individualized Development Care and Assessment Program (NIDCAP) incorporates many aspects of developmental care and focuses on individualised family-oriented care.

Objectives To evaluate the effect of NIDCAP on neurodevelopmental and clinical outcomes in the preterm infant in the first 2 years.

Data sources MEDLINE database and the Cochrane Library.

Study eligibility criteria Randomised controlled trials (RCTs) published from 1990 to 2011 in all languages.

Participants Preterm infants less than 33 weeks of gestational age and less than 2500 g at birth.

Intervention and outcomes The Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) components of the Bayley Scales of Infant Development Second Edition (BSID II) were compared in NIDCAP intervention and standard of care (SOC) groups. The secondary outcomes were the Assessment of Preterm Infant's Behavior (APIB) scales, length of hospital stay, days of mechanical ventilation, Continuous Positive Airway Pressure (CPAP) therapy and oxygen therapy. Intraventricular haemorrhage, necrotising enterocolitis, bronchopulmonary dysplasia and retinopathy of prematurity are compared between the groups.

Results Among the nine articles included, which reported on studies with a total of 503 infants, the NIDCAP group significantly outperformed the control group for the MDI (difference: 11.66; 95% CI (6.47 to 16.85), I²=72%, p<0.0001) and the PDI (difference: 8.32; 95% CI (3.48 to 13.17), I²=57%, p=0.0008). Similar significant results were found for the APIB scales.

Conclusions Compared to the SOC, NIDCAP has the potential to improve mental and psychomotor development clinically and statistically even if the long-term effect is uncertain.

  • Neonatology
  • Neurodevelopment
  • Nursing Care

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