Infant Behavior & Development 39 (2015) 166–172
Contents lists available at ScienceDirect
Infant Behavior and Development
Effect of developmental care for very premature infants on neurodevelopmental outcome at 2 years of age Ursula Kiechl-Kohlendorfer a,∗ , Ute Merkle a,b , Daniela Deufert b , Vera Neubauer a , Ulrike Pupp Peglow a , Elke Griesmaier a a
Department of Pediatrics, Division of Neonatology, Medical University of Innsbruck, Innsbruck, Austria Department of Nursing Science and Gerontology, Institute for Nursing Science, University for Healthy Sciences, Medical Informatics and Technology, Hall/Tyrol, Austria b
a r t i c l e
i n f o
Article history: Received 2 November 2014 Received in revised form 12 February 2015 Accepted 15 February 2015 Keywords: Developmental care Outcome Preterm infants
a b s t r a c t Background: To determine the effect of developmental care on neurodevelopmental outcome in formerly preterm infants at a corrected age of 2 years. Methods: A prospective phase-lag study was performed at an Austrian neonatal intensive care unit (NICU). From January 2003 to December 2005 (study period of conventional care) and January 2007 to December 2009 (study period of developmental care), we enrolled all infants born in Tyrol at less than 32 weeks of gestation. During this period a total of 261 of 359 preterm infants (participation rate 72.7%) completed the follow-up visit at 2 years of age; there were 124 children in the conventional and 137 in the developmental care group. The association between developmental care and delayed motor or mental development (Bayley Scales of Infant Development II; psychomotor or mental developmental index 2 SDs below the mean) significant delay. Psychomotor or cognitive delay was defined as a score of less than 85 in the Bayley II test. Children in whom a score could not be calculated because of severe psychomotor or mental delay were also classified as having delayed developmental abilities. 2.5. Statistical analysis Data analysis was performed with SPSS software, version 20.0, for Windows (SPSS Inc., Chicago, IL, USA). Categorical data were compared using the chi-squared or Fischer’s exact test. The Bonferroni correction for multiple comparisons was performed. Multivariate risk profiles for delay in psychomotor and mental abilities were computed by means of logistic regression analysis using a stepwise forward selection procedure with in- and exclusion criteria as follows (PI < 0.05 and PE > 0.10). This analysis allows for the following variables: low educational level of mother, smoking in pregnancy, multiple births, antenatal steroids, gestational age (per 1-week increase), birth weight, male sex, surfactant treatment, CLD, ICH all grades and grades 3 and 4, PVL, NEC, ROP grades 3 and 4, and early- and late-onset sepsis. 3. Results Table 1 summarizes maternal, pre-, peri-, and neonatal data for the population of children born before 32 gestational weeks in the conventional care (n = 250) and the individualized developmental care (n = 208) groups. Except for the prevalence of low maternal age (
Contents lists available at ScienceDirect
Infant Behavior and Development
Effect of developmental care for very premature infants on neurodevelopmental outcome at 2 years of age Ursula Kiechl-Kohlendorfer a,∗ , Ute Merkle a,b , Daniela Deufert b , Vera Neubauer a , Ulrike Pupp Peglow a , Elke Griesmaier a a
Department of Pediatrics, Division of Neonatology, Medical University of Innsbruck, Innsbruck, Austria Department of Nursing Science and Gerontology, Institute for Nursing Science, University for Healthy Sciences, Medical Informatics and Technology, Hall/Tyrol, Austria b
a r t i c l e
i n f o
Article history: Received 2 November 2014 Received in revised form 12 February 2015 Accepted 15 February 2015 Keywords: Developmental care Outcome Preterm infants
a b s t r a c t Background: To determine the effect of developmental care on neurodevelopmental outcome in formerly preterm infants at a corrected age of 2 years. Methods: A prospective phase-lag study was performed at an Austrian neonatal intensive care unit (NICU). From January 2003 to December 2005 (study period of conventional care) and January 2007 to December 2009 (study period of developmental care), we enrolled all infants born in Tyrol at less than 32 weeks of gestation. During this period a total of 261 of 359 preterm infants (participation rate 72.7%) completed the follow-up visit at 2 years of age; there were 124 children in the conventional and 137 in the developmental care group. The association between developmental care and delayed motor or mental development (Bayley Scales of Infant Development II; psychomotor or mental developmental index 2 SDs below the mean) significant delay. Psychomotor or cognitive delay was defined as a score of less than 85 in the Bayley II test. Children in whom a score could not be calculated because of severe psychomotor or mental delay were also classified as having delayed developmental abilities. 2.5. Statistical analysis Data analysis was performed with SPSS software, version 20.0, for Windows (SPSS Inc., Chicago, IL, USA). Categorical data were compared using the chi-squared or Fischer’s exact test. The Bonferroni correction for multiple comparisons was performed. Multivariate risk profiles for delay in psychomotor and mental abilities were computed by means of logistic regression analysis using a stepwise forward selection procedure with in- and exclusion criteria as follows (PI < 0.05 and PE > 0.10). This analysis allows for the following variables: low educational level of mother, smoking in pregnancy, multiple births, antenatal steroids, gestational age (per 1-week increase), birth weight, male sex, surfactant treatment, CLD, ICH all grades and grades 3 and 4, PVL, NEC, ROP grades 3 and 4, and early- and late-onset sepsis. 3. Results Table 1 summarizes maternal, pre-, peri-, and neonatal data for the population of children born before 32 gestational weeks in the conventional care (n = 250) and the individualized developmental care (n = 208) groups. Except for the prevalence of low maternal age (
