Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2020

01-12-2020 | Care | Research article

Do NICU developmental care improve cognitive and motor outcomes for preterm infants? A systematic review and meta-analysis

Authors: Farin Soleimani, Nadia Azari, Hesam Ghiasvand, Amin Shahrokhi, Nahid Rahmani, Shiva Fatollahierad

Published in: BMC Pediatrics | Issue 1/2020

Login to get access

Abstract

Background

The aim of this study was to review the effects of developmental care in neonatal intensive care unit (NICU) setting on mental and motor development of preterm infants.

Method

We searched PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane library until October 8th 2017, and included randomized controlled trials that assessed effects of developmental care in NICU on mental and motor development of preterm infants at 12 and 24 months of age, using the Bayley scale of infant development in this systematic review. In addition, data were pooled by random effects model and Standardized Mean Difference (SMD) with 95% confidence intervals (CI), calculated for meta-analysis.

Results

Twenty one studies were eligible to be included in this systematic review; however, only thirteen studies had data suitable for meta-analysis. According to statistical analysis, developmental care in NICU improved mental developmental index (MDI) (standardized mean difference [SMD] 0.55, 95% confidence interval [CI] 0.23–0.87; p < 0.05), and psychomotor developmental index (PDI) (SMD 0.33, [CI] 95% CI 0.08–0.57; p < 0.05) of BSID at 12 months of age and PDI at 24 months of age (SMD 0.15, 95% CI -0.02–0.32; p < 0.1) of preterm infants. However, the benefit was not detected at 24 months of age on MDI (SMD 0.15, 95% CI -0.05–0.35; p = 0.15).

Conclusion

Current evidence suggests that developmental care in only NICU setting could have significant effect on mental and motor development of preterm infants, especially at 12 months of age. However, because of clinical heterogeneity, more studies are needed to evaluate the effects of developmental NICU care in the development of preterm infants.
Appendix
Available only for authorised users
Literature
1.
Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under−5 mortality in 2000–15: an updated systematic analysis with implications for the sustainable development goals. Lancet. 2016;388(10063):3027–35.PubMedPubMedCentral
2.
3.
4.
Soleimani F, Teymouri R, Biglarian A. Predicting developmental disorder in infants using an artificial neural network. Acta Medica Iranica. 2013:347–52.
5.
Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008;371(9608):261–9.PubMed
6.
Johnston KM, Gooch K, Korol E, Vo P, Eyawo O, Bradt P, et al. The economic burden of prematurity in Canada. BMC Pediatr. 2014;14(1):93.PubMedPubMedCentral
7.
Altimier L, Phillips R. The neonatal integrative developmental care model: advanced clinical applications of the seven Core measures for Neuroprotective family-centered developmental care. Newborn Infant Nurs Rev. 2016;16(4):230–44.
8.
Volpe JJ. Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol. 2009;8(1):110–24.PubMedPubMedCentral
9.
Graven SN, Browne JV. Sensory development in the fetus, neonate, and infant: introduction and overview. Newborn Infant Nurs Rev. 2008;8(4):169–72.
10.
Altimier LB. Neuroprotective core measure 1: the healing NICU environment. Newborn Infant Nurs Rev. 2015;15(3):91–6.
11.
Sizun J, Westrup B. Early developmental care for preterm neonates: a call for more research. Arch Dis Child Fetal Neonatal Ed. 2004;89(5):F384–8.PubMedPubMedCentral
12.
Rafiey H, Soleimani F, Torkzahrani S, Salavati M, Nasiri M. Scale development and psychometrics for parents’ satisfaction with developmental Care in Neonatal Intensive Care Unit. Iran J Child Neurol. 2016;10(4):16.PubMedPubMedCentral
13.
14.
Pickler RH, McGrath JM, Reyna BA, McCain N, Lewis M, Cone S, et al. A model of neurodevelopmental risk and protection for preterm infants. I Perinat Neonatal nurs. 2010;24(4):356–65.
15.
Orton J, Spittle A, Doyle L, Anderson P, Boyd R. Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review. Dev Med Child Neurol. 2009;51(11):851–9.PubMed
16.
Spittle A, Orton J, Anderson PJ, Boyd R, Doyle LW. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database Syst Rev. 2015;11.
17.
Lavallée A, De Clifford-Faugère G, Garcia C, Oviedo ANF, Héon M, Aita M. Part 1: narrative overview of developmental care interventions for the preterm newborn. J Neonatal Nurs. 2018.
18.
Jacobs SE, Sokol J, Ohlsson A. The newborn individualized developmental care and assessment program is not supported by meta-analyses of the data. Journal pediatr. 2002;140(6):699–706.
19.
Vanderveen J, Bassler D, Robertson C, Kirpalani H. Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis. J Perinatol: official journal of the California Perinatal Association. 2009;29(5):343.
20.
Benzies KM, Magill-Evans JE, Hayden KA, Ballantyne M. Key components of early intervention programs for preterm infants and their parents: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013;13(1):S10.PubMedPubMedCentral
21.
22.
Aylward GP. Cognitive and neuropsychological outcomes: more than IQ scores. Ment Retard Dev Disabil Res Rev. 2002;8(4):234–40.PubMed
23.
Bayley N. Manual for the Bayley scales of infant development: psychological corporation; 1969.
24.
Bayley N. Bayley scales of infant development: manual: psychological corporation; 1993.
25.
Bayley N. Bayley scales of infant and toddler development: Bayley-III: Harcourt assessment. San Antonio, TX: Psych. Corporation; 2006.
26.
Potharst ES, Houtzager BA, van Sonderen L, Tamminga P, Kok JH, Last BF, et al. Prediction of cognitive abilities at the age of 5 years using developmental follow-up assessments at the age of 2 and 3 years in very preterm children. Dev Med Child Neurol. 2012;54(3):240–6.PubMed
27.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.PubMedPubMedCentral
28.
Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ (Clin Res ed). 2011;343:d5928.
29.
30.
Faraone SV. Interpreting estimates of treatment effects: implications for managed care. Pharm Ther. 2008;33(12):700.
31.
Ryan R, Hill S. How to GRADE the quality of the evidence.: Cochrane Consumers and Commun Group; 2016 [.
32.
Kiechl-Kohlendorfer U, Merkle U, Deufert D, Neubauer V, Peglow UP, Griesmaier E. Effect of developmental care for very premature infants on neurodevelopmental outcome at 2 years of age. Infant Behav Devel. 2015;39:166–72.
33.
Pineda RG, Neil J, Dierker D, Smyser CD, Wallendorf M, Kidokoro H, et al. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. Journal of pediatrics. 2014;164(1):52–60.e2.
34.
Gabis LV, Hacham-Pilosof K, Yosef OB, Rabinovitz G, Leshem G, Shilon-Hadass A, et al. The influence of a multisensory intervention for preterm infants provided by parents, on developmental abilities and on parental stress levels. J Child Neurol. 2015;30(7):896–903.PubMed
35.
Leib SA, Benfield DG, Guidubaldi J. Effects of early intervention and stimulation on the preterm infant. Pediatr. 1980;66(1):83–90.
36.
Als H, Lawhon G, Brown E, Gibes R, Duffy FH, McAnulty G, et al. Individualized behavioral and environmental care for the very low birth weight preterm infant at high risk for bronchopulmonary dysplasia: neonatal intensive care unit and developmental outcome. Pediatr. 1986;78(6):1123–32.
37.
Vohr B, McGowan E, McKinley L, Tucker R, Keszler L, Alksninis B. Differential Effects of the Single-Family Room Neonatal Intensive Care Unit on 18- to 24-Month Bayley Scores of Preterm Infants. J Pediat. 2017;185:42–8.e1.PubMed
38.
Abdallah B, Badr LK, Hawwari M. The efficacy of massage on short and long term outcomes in preterm infants. Infant Behav Dev. 2013;36(4):662–9.PubMed
39.
Kaaresen PI, Ronning JA, Tunby J, Nordhov SM, Ulvund SE, Dahl LB. A randomized controlled trial of an early intervention program in low birth weight children: outcome at 2 years. Early Hum Dev. 2008;84(3):201–9.PubMed
40.
Van Hus J, Jeukens-Visser M, Koldewijn K, Holman R, Kok JH, Nollet F, et al. Early intervention leads to long-term developmental improvements in very preterm infants, especially infants with bronchopulmonary dysplasia. Acta paediatrica (Oslo, Norway : 1992). 2016;105(7):773–81.
41.
Jeng S-F, Wu Y-C, Leng C-H, Hsieh W-S, Hsu C-H, Chen W, et al. Early interventions for very low birth weight preterm infants: effects and mediators. Physiother. 2015;101:e676.
42.
Teti DM, Black MM, Viscardi R, Glass P, O'Connell MA, Baker L, et al. Intervention with African American premature infants: four-month results of an early intervention program. J Early Interv. 2009;31(2):146–66.
43.
Nordhov SM, Ronning JA, Dahl LB, Ulvund SE, Tunby J, Kaaresen PI. Early intervention improves cognitive outcomes for preterm infants: randomized controlled trial. Pediatrics. 2010;126(5):e1088–94.PubMed
44.
Brooks-Gunn J, Liaw F-R, Klebanov PK. Effects of early intervention on cognitive function of low birth weight preterm infants. J Pediatr. 1992;120(3):350–9.PubMed
45.
Abou Turk C, Williams AL, Lasky RE. A randomized clinical trial evaluating silicone earplugs for very low birth weight newborns in intensive care. J Perinatol: official journal of the California Perinatal Association. 2009;29(5):358–63.
46.
Als H, Lawhon G, Duffy FH, McAnulty GB, Gibes-Grossman R, Blickman JG. Individualized developmental care for the very low-birth-weight preterm infant. Medical and neurofunctional effects. Jama. 1994;272(11):853–8.PubMed
47.
Als H, Duffy FH, McAnulty GB, Rivkin MJ, Vajapeyam S, Mulkern RV, et al. Early experience alters brain function and structure. Pediatr. 2004;113(4):846–57.
48.
Als H, Duffy FH, McAnulty GB, Fischer CB, Kosta S, Butler SC, et al. Is the newborn individualized developmental care and assessment program (NIDCAP) effective for preterm infants with intrauterine growth restriction? J Perinatol: official journal of the California Perinatal Assoc. 2011;31(2):130–6.
49.
Als H, Duffy FH, McAnulty G, Butler SC, Lightbody L, Kosta S, et al. NIDCAP improves brain function and structure in preterm infants with severe intrauterine growth restriction. J Perinatol: official Journal California Perinatal Association. 2012;32(10):797–803.
50.
Ariagno RL, Thoman EB, Boeddiker MA, Kugener B, Constantinou JC, Mirmiran M, et al. Developmental care does not alter sleep and development of premature infants. Pediatr. 1997;100(6):E9.
51.
Brandon DH, Silva SG, Park J, Malcolm W, Kamhawy H, Holditch-Davis D. Timing for the introduction of cycled light for extremely preterm infants: a randomized controlled trial. Res Nurs Health. 2017;40(4):294–310.PubMedPubMedCentral
52.
Brown J, LaRossa M, Aylward G, Davis D, Rutherford P, Bakeman R. Nursery-based intervention with prematurely born babies and their mothers: are there effects? J Pediatr. 1980;97(3):487–91.PubMed
53.
Fajardo B, Browning M, Fisher D, Paton J. Early state organization and follow-up over one year. J Dev Behav Pediatr. 1992;13(2):83–8.PubMed
54.
Fajardo B, Browning M, Fisher D, Paton J. Early state organization and follow-up over one year. J Dev behavioral pediatrics : JDBP. 1992;13(2):83–8.
55.
Feeley N, Zelkowitz P, Shrier I, Stremler R, Westreich R, Dunkley D, et al. Follow-up of the cues and care trial: mother and infant outcomes at 6 months. J Early Interv. 2012;34(2):65–81.
56.
Guyer C, Huber R, Fontijn J, Bucher HU, Nicolai H, Werner H, et al. Cycled light exposure reduces fussing and crying in very preterm infants. Pediatr. 2012;130(1):e145–51.
57.
Kramer M, Chamorro I, Green D, Knudtson F. Extra tactile stimulation of the premature infant. Nurs Res. 1975;24(5):324–34.PubMed
58.
Maguire CM, Walther FJ, van Zwieten PH, Le Cessie S, Wit JM, Veen S. No change in developmental outcome with incubator covers and nesting for very preterm infants in a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2009;94(2):F92–7.PubMed
59.
Maguire CM, Walther FJ, van Zwieten PH, Le Cessie S, Wit JM, Veen S. Follow-up outcomes at 1 and 2 years of infants born less than 32 weeks after newborn individualized developmental care and assessment program. Pediatrics. 2009;123(4):1081–7.PubMed
60.
McAnulty G, Duffy FH, Butler S, Parad R, Ringer S, Zurakowski D, et al. Individualized developmental care for a large sample of very preterm infants: health, neurobehaviour and neurophysiology. Acta paediatrica (Oslo, Norway : 1992). 2009;98(12):1920–6.
61.
Parker SJ, Zahr LK, Cole JG, Brecht ML. Outcome after developmental intervention in the neonatal intensive care unit for mothers of preterm infants with low socioeconomic status. J Pediatr. 1992;120(5):780–5.PubMed
62.
Peters KL, Rosychuk RJ, Hendson L, Cote JJ, McPherson C, Tyebkhan JM. Improvement of short- and long-term outcomes for very low birth weight infants: Edmonton NIDCAP trial. Pediatr. 2009;124(4):1009–20.
63.
Powell LF. The effect of extra stimulation and maternal involvement on the development of low-birth-weight infants and on maternal behavior. Child Dev. 1974:106–13.PubMed
64.
Procianoy RS, Mendes EW, Silveira RC. Massage therapy improves neurodevelopment outcome at two years corrected age for very low birth weight infants. Early Hum Dev. 2010;86(1):7–11.PubMed
65.
Szajnberg N, Ward MJ, Krauss A, Kessler DB. Low birth-weight prematures: preventive intervention and maternal attitude. Child Psychiatry Hum Dev. 1987;17(3):152–65.PubMed
66.
Welch MG, Firestein MR, Austin J, Hane AA, Stark RI, Hofer MA, et al. Family nurture intervention in the neonatal intensive care unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial. J ChildPsychol Psychiatry, Allied Discip. 2015;56(11):1202–11.
Metadata
Title
Do NICU developmental care improve cognitive and motor outcomes for preterm infants? A systematic review and meta-analysis
Authors
Farin Soleimani
Nadia Azari
Hesam Ghiasvand
Amin Shahrokhi
Nahid Rahmani
Shiva Fatollahierad
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Pediatrics / Issue 1/2020
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-020-1953-1

Other articles of this Issue 1/2020

BMC Pediatrics 1/2020 Go to the issue

Research article

Application of the adenosine triphosphate sensitivity assay in infantile vascular anomalies

Research article

Etiological serotype and genotype distributions and clinical characteristics of group B streptococcus-inducing invasive disease among infants in South China

Research article

Age- and gender-specific trends in respiratory outpatient visits and diagnoses at a tertiary pediatric hospital in China: a 10-year retrospective study

Research article

Hypoxic/ischemic hits predispose to necrotizing enterocolitis in (near) term infants with congenital heart disease: a case control study

Research article

Vitamin D toxicity in a pediatric toxicological referral center; a cross-sectional study from Iran

Case report

Severe constipation as the first clinical manifestation in multiple endocrine neoplasia type 2B: a case report and literature review