Elsevier

The Journal of Pediatrics

Volume 155, Issue 4, October 2009, Pages 488-494.e1
The Journal of Pediatrics

Original Article
Randomized Trial of a Parenting Intervention for Very Preterm Infants: Outcome at 2 Years

https://doi.org/10.1016/j.jpeds.2009.04.013Get rights and content

Objectives

To determine the efficacy of a neonatal parenting intervention for improving development in very preterm infants.

Study design

A cluster-randomized, controlled trial with a cross-over design and washout period was conducted in 6 neonatal centers. Two hundred thirty-three babies <32 weeks' gestation were recruited (intervention = 112; control = 121). Intervention families received weekly Parent Baby Interaction Programme (PBIP) sessions during neonatal intensive care unit admission and up to 6 weeks after discharge. Control families received standard care. All 195 infants remaining in the study at 24 months' corrected age were assessed by psychologists blinded to group allocation.

Results

There was no significant difference in Mental Development Index (−0.9 points; 95% CI, −5.0, 3.2) or Psychomotor Development Index (2.5; −3.3, 8.4) scores between the intervention and control groups and no significant effect of intervention on Mental Development Index or Psychomotor Development Index scores for subgroups dichotomized by gestational age (<28 weeks/≥28 weeks), parity (1st/other child) or mother's cohabiting status (supported/unsupported).

Conclusions

There was no effect of PBIP on infant development at 2 years' corrected age. Parenting interventions may be better delivered after discharge or targeted for preterm infants with high biological and social risk.

Section snippets

Methods

The study design (ISRCTN56341521) has been described in detail previously.14 Briefly, a cluster-randomized, controlled trial with a cross-over design was conducted in 6 neonatal centers (incorporating 7 NICUs) in 2 regions of the United Kingdom (3 each in the South West and Trent regions). Approval was obtained from the South West multi-center ethics committee and the local research ethics committees at each center. Within regions, 2 centers were paired on the basis of deprivation indices, and

Results

The derivation of this cohort has been described previously.14 Of 496 babies born at <32 weeks at participating centers, 156 were excluded and 33 died before obtaining consent. Of the remaining 307 babies, 233 (76%) were recruited to the study: 112 (81% of those eligible) to the intervention group and 121 (72% of those eligible) to the control. There were no significant differences in sex, birth weight, gestational age and multiple births between babies who were and were not recruited to the

Discussion

In this rigorous randomized, controlled trial, there was no significant effect of the PBIP16 on cognitive development at 2 years' corrected age in very preterm infants. This result is perhaps not entirely unexpected because trials investigating the efficacy of parenting interventions for very preterm infants have generally produced variable and conflicting results. Although some studies have reported beneficial effects of intervention on cognitive outcomes,11, 12, 21 others have failed to

References (32)

  • M. Forcada-Guex et al.

    Early dyadic patterns of mother-infant interactions and outcomes of prematurity at 18 months

    Pediatrics

    (2006)
  • A.J. Spittle et al.

    Cochrane review: early developmental intervention programs post hospital discharge to prevent motor and cognitive impairments in preterm infants

    Evidence-Based Child Health: A Cochrane Review Journal

    (2008)
  • M. Barrera et al.

    Low birth weight and home intervention strategies: preterm infants

    Dev Behav Pediatr

    (1986)
  • T.M. Achenbach et al.

    Nine year outcome of the Vermont program for low birthweight infants

    Pediatrics

    (1993)
  • C. Glazebrook et al.

    Randomised trial of a parenting intervention during neonatal intensive care

    Arch Dis Childhood Fetal Neonatal Ed

    (2007)
  • M. Noble et al.

    The English Indices of Deprivation

    (2004)
  • Cited by (0)

    Supported by the Health Foundation, London, United Kingdom

    The authors have no conflicts of interest to declare.

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