Skip to main content
Top
Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Study protocol

Early intervention program for very low birth weight preterm infants and their parents: a study protocol

Authors: Rita C. Silveira, Eliane Wagner Mendes, Rubia Nascimento Fuentefria, Nadia Cristina Valentini, Renato S. Procianoy

Published in: BMC Pediatrics | Issue 1/2018

Login to get access

Abstract

Background

Preterm infants are high risk for delayed neurodevelopment. The main goal is to develop a program of early intervention for very preterm infants that allows families to apply it continuously at home, and quantify the results of early parental stimulation on improvement of cognition and motor skills.

Methods

Randomized clinical Trial including inborn preterm infants with gestational age less than 32 weeks or birth weight less than 1500 g at 48 h after birth. Eligible for begin the intervention up to 7 days after birth. Study Protocol approved by the Brazilian national Committee of ethics in Research and by the institutional ethics committee.
Intervention group (IG): skin-to skin care by mother (kangaroo care) plus tactile-kinesthetic stimulation by mothers from randomization until hospital discharge when they receive a program of early intervention with 10 parents’ orientation and a total of 10 home visits independently of the standard evaluation and care that will be performed. Systematic early intervention program will be according to developmental milestones, anticipating in a month evolutionary step acquisition of motor and / or cognitive expected for corrected age. Active comparator with a Conventional Group (CG): standard care according to the routine care of the NICU and their needs in the follow up program. Neurodevelopment outcome with blinded evaluations in both groups between 12 and 18 months by Bayley Scales of Infant and Toddler Development third edition and Alberta Motor Infant scale will be performed. All evaluations will be conducted in the presence of parents or caregivers in a safe room for the child move around during the evaluation.

Discussion

If we can show that a continuous and global early intervention at home performed by low income families is better than the standard care for very preterm infants, this kind of program may be applied elsewhere in the world. We received grants by Bill and Melinda Gates Foundation, DECIT, Cnpq and Health Ministry. Grand Challenges Brazil: All Children Thriving.

Trial registration

The study was restrospectively registered in ClinicalTrials.​gov. in July 15 2016 (NCT02835612).
Literature
1.
go back to reference March of Dimes, PMNCH, Save the Children, WHO. Born too Soon : The global action report on preterm birth. World Health Organization. Geneva, 2012. March of Dimes, PMNCH, Save the Children, WHO. Born too Soon : The global action report on preterm birth. World Health Organization. Geneva, 2012.
2.
go back to reference Guinsburg R, de Almeida MF, de Castro JS, Silveira RC, Caldas JP, Fiori HH, et al. Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers. J Matern Fetal Neonatal Med. 2015;2:1–5. Guinsburg R, de Almeida MF, de Castro JS, Silveira RC, Caldas JP, Fiori HH, et al. Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers. J Matern Fetal Neonatal Med. 2015;2:1–5.
3.
go back to reference American Academy of Pediatrics. Follow-up care of high-risk infants. Pediatrics. 2004;114:1377–97.CrossRef American Academy of Pediatrics. Follow-up care of high-risk infants. Pediatrics. 2004;114:1377–97.CrossRef
4.
go back to reference Vohr BR, Wright LL, Poole WK, McDonald SA. Neurodevelopmental outcomes of extremely low birth weight infants neurodevelopmental outcomes of extremely low birth weight infants <32 weeks' gestation between 1993 and 1998. Pediatrics. 2005;116:635–43.CrossRefPubMed Vohr BR, Wright LL, Poole WK, McDonald SA. Neurodevelopmental outcomes of extremely low birth weight infants neurodevelopmental outcomes of extremely low birth weight infants <32 weeks' gestation between 1993 and 1998. Pediatrics. 2005;116:635–43.CrossRefPubMed
5.
go back to reference Spittle A, Orion J, Anderson P, Boyd R, Doyle LW. Early developmental intervention programmes post-hospital discharge to prevent motor and cognitive impairments in preterm infants. Cochrane Database Syst Rev. 2012; issue 12 Art n :CD005495 Spittle A, Orion J, Anderson P, Boyd R, Doyle LW. Early developmental intervention programmes post-hospital discharge to prevent motor and cognitive impairments in preterm infants. Cochrane Database Syst Rev. 2012; issue 12 Art n :CD005495
6.
go back to reference Landsem IP, Handegård BH, Tunby J, Ulvund SE, Rønning JA. Early intervention program reduces stress in parents of preterms during childhood, a randomized controlled trial. Trials. 2014;15:387.CrossRefPubMedPubMedCentral Landsem IP, Handegård BH, Tunby J, Ulvund SE, Rønning JA. Early intervention program reduces stress in parents of preterms during childhood, a randomized controlled trial. Trials. 2014;15:387.CrossRefPubMedPubMedCentral
7.
go back to reference Morgan C, Novak I, Badawi N. Enriched environments and motor outcomes in cerebral palsy: systematic review and meta-analysis. Pediatrics. 2013;132(3):e735–46.CrossRefPubMed Morgan C, Novak I, Badawi N. Enriched environments and motor outcomes in cerebral palsy: systematic review and meta-analysis. Pediatrics. 2013;132(3):e735–46.CrossRefPubMed
8.
go back to reference Melnyk BM, Alpert-Gillis L, Feinstein NF, Fairbanks E, Czarniak-Schultz N, Hust D, et al. Improving cognitive development of low-birth-weight premature infants with the COPE program: a pilot study of the benefit of early NICU intervention with mothers. Res Nurs Health. 2001;24(5):373–89.CrossRefPubMed Melnyk BM, Alpert-Gillis L, Feinstein NF, Fairbanks E, Czarniak-Schultz N, Hust D, et al. Improving cognitive development of low-birth-weight premature infants with the COPE program: a pilot study of the benefit of early NICU intervention with mothers. Res Nurs Health. 2001;24(5):373–89.CrossRefPubMed
9.
go back to reference Field T. Preterm infant massage therapy studies: an American approach. Semin Neonatol. 2002;7:487–94.CrossRefPubMed Field T. Preterm infant massage therapy studies: an American approach. Semin Neonatol. 2002;7:487–94.CrossRefPubMed
11.
go back to reference Anderson P, Doyle LW, Victorian Infant Collaborative Study Group. Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. JAMA. 2003;289:3264–72.CrossRefPubMed Anderson P, Doyle LW, Victorian Infant Collaborative Study Group. Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. JAMA. 2003;289:3264–72.CrossRefPubMed
12.
go back to reference Seidman G, Unnikrishnan S, Kenny E, Myslinski S, Cairns-Smith S, Mulligan B, Engmann C. Barriers and enablers of kangaroo mother care practice: a systematic review. PLoS One. 2015;10:e0125643.CrossRefPubMedPubMedCentral Seidman G, Unnikrishnan S, Kenny E, Myslinski S, Cairns-Smith S, Mulligan B, Engmann C. Barriers and enablers of kangaroo mother care practice: a systematic review. PLoS One. 2015;10:e0125643.CrossRefPubMedPubMedCentral
13.
go back to reference Barros FC, Bhutta ZA, Batra M, et al. Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions. BMC Pregnancy Childbirth. 2010;10(Suppl 1):S3.CrossRefPubMedPubMedCentral Barros FC, Bhutta ZA, Batra M, et al. Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions. BMC Pregnancy Childbirth. 2010;10(Suppl 1):S3.CrossRefPubMedPubMedCentral
14.
go back to reference Valentini NC, Saccani R. Escala Motora Infantil de Alberta: validação para uma população gaúcha. Rev Paul Pediatr. 2011;29(2):231–8.CrossRef Valentini NC, Saccani R. Escala Motora Infantil de Alberta: validação para uma população gaúcha. Rev Paul Pediatr. 2011;29(2):231–8.CrossRef
15.
go back to reference Bayley N. Manual for the Bayley scales of infant and toddler development. 3rd ed. San Antonio, TX: Psychological Corporation; 2006. Bayley N. Manual for the Bayley scales of infant and toddler development. 3rd ed. San Antonio, TX: Psychological Corporation; 2006.
16.
17.
go back to reference Bond C. Positive touch and massage in the neonatal unit: a British approach. Semin Neonatol. 2002;7:477–86.CrossRefPubMed Bond C. Positive touch and massage in the neonatal unit: a British approach. Semin Neonatol. 2002;7:477–86.CrossRefPubMed
18.
go back to reference Litmanovitz I, Dolfin T, Friedland O, Arnon S, Regev R, Shainkin-Kestenbaum R, et al. Early physical activity intervention prevents decrease of bone strength in very low birth weight infants. Pediatrics. 2003;112:15–9.CrossRefPubMed Litmanovitz I, Dolfin T, Friedland O, Arnon S, Regev R, Shainkin-Kestenbaum R, et al. Early physical activity intervention prevents decrease of bone strength in very low birth weight infants. Pediatrics. 2003;112:15–9.CrossRefPubMed
19.
go back to reference Mendes EW, Procianoy RS. Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates. J Perinatol. 2008;28:815–30.CrossRefPubMed Mendes EW, Procianoy RS. Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates. J Perinatol. 2008;28:815–30.CrossRefPubMed
20.
go back to reference Terra L, Hauck S, Schestatsky S, Fillipon AP, Sanchez P, Hirakata V, Ceitlin LH. Confirmatory factor analysis of the parental bonding instrument in a Brazilian female population. Aust N Z J Psychiatry. 2009;43:348–54.CrossRefPubMed Terra L, Hauck S, Schestatsky S, Fillipon AP, Sanchez P, Hirakata V, Ceitlin LH. Confirmatory factor analysis of the parental bonding instrument in a Brazilian female population. Aust N Z J Psychiatry. 2009;43:348–54.CrossRefPubMed
21.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
22.
go back to reference Petersen MC, Kube DA, Palmer FB. Classification of developmental delays. Semin Pediatr Neurol. 1998;5:2–14.CrossRefPubMed Petersen MC, Kube DA, Palmer FB. Classification of developmental delays. Semin Pediatr Neurol. 1998;5:2–14.CrossRefPubMed
23.
go back to reference Chan A-W, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin J, Dickersin K, Hróbjartsson A, Schulz KF, Parulekar WR, Krleža-Jerić K, Laupacis A, Moher D. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586.CrossRefPubMedPubMedCentral Chan A-W, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin J, Dickersin K, Hróbjartsson A, Schulz KF, Parulekar WR, Krleža-Jerić K, Laupacis A, Moher D. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586.CrossRefPubMedPubMedCentral
24.
25.
go back to reference Morgan C, Novak I, Dale RC, Guzzetta A, Badawi N. GAME (Goals - Activity - Motor Enrichment): protocol of a single blind randomised controlled trial of motor training, parent education and environmental enrichment for infants at high risk of cerebral palsy. BMC Neurol. 2014;14:203.CrossRefPubMedPubMedCentral Morgan C, Novak I, Dale RC, Guzzetta A, Badawi N. GAME (Goals - Activity - Motor Enrichment): protocol of a single blind randomised controlled trial of motor training, parent education and environmental enrichment for infants at high risk of cerebral palsy. BMC Neurol. 2014;14:203.CrossRefPubMedPubMedCentral
26.
go back to reference Roberts MY, Kaiser AP, Wolfe CE, Bryant JD, Spidalieri AM. Effects of the teach-model-coach-review instructional approach on caregiver use of language support strategies and children's expressive language skills. J Speech Lang Hear Res. 2014;57(5):1851–69.CrossRefPubMed Roberts MY, Kaiser AP, Wolfe CE, Bryant JD, Spidalieri AM. Effects of the teach-model-coach-review instructional approach on caregiver use of language support strategies and children's expressive language skills. J Speech Lang Hear Res. 2014;57(5):1851–69.CrossRefPubMed
27.
go back to reference Biringen Z, Derscheid D, Vliegen N, Closson L, Easterbrooks MA. Emotional availability (EA): theoretical background, empirical research using the EA scales, and clinical applications. Dev Rev. 2012;34(2):114–67.CrossRef Biringen Z, Derscheid D, Vliegen N, Closson L, Easterbrooks MA. Emotional availability (EA): theoretical background, empirical research using the EA scales, and clinical applications. Dev Rev. 2012;34(2):114–67.CrossRef
Metadata
Title
Early intervention program for very low birth weight preterm infants and their parents: a study protocol
Authors
Rita C. Silveira
Eliane Wagner Mendes
Rubia Nascimento Fuentefria
Nadia Cristina Valentini
Renato S. Procianoy
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-1240-6

Other articles of this Issue 1/2018

BMC Pediatrics 1/2018 Go to the issue