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Preventive care at home for very preterm infants improves infant and caregiver outcomes at 2 years.

TitlePreventive care at home for very preterm infants improves infant and caregiver outcomes at 2 years.
Publication TypeJournal Article
Year of Publication2010
AuthorsSpittle AJ, Anderson PJ, Lee KJ, Ferretti C, Eeles A, Orton J, Boyd RN, Inder T, Doyle LW
JournalPediatrics
Volume126
Issue1
Paginatione171-8
Date Published2010 Jul
ISSN1098-4275
KeywordsCaregivers, Child Behavior, Child Development, Child, Preschool, Confidence Intervals, Continuity of Patient Care, Developmental Disabilities, Early Intervention (Education), Female, Follow-Up Studies, Home Care Services, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Male, Mother-Child Relations, Odds Ratio, Risk Assessment, Treatment Outcome
Abstract

OBJECTIVE: The objective of this study was to determine the effects of preventive care at home on child development and primary caregiver mental health at 2 years of age.

METHODS: A total of 120 very preterm infants (<30 weeks) were assigned randomly to intervention (n = 61) or control (n = 59) groups. The intervention group received the preventive care program (9 home visits over the first year from a physiotherapist and a psychologist, focusing on the parent-infant relationship, the parents' mental health, and the infant's development); and the control group received standard care. At corrected age of 2 years, developmental outcomes were assessed, and primary caregivers completed the Infant-Toddler Social and Emotional Assessment. The mental health of the primary caregivers was assessed with the Hospital Anxiety and Depression Scale.

RESULTS: At 2 years of age, 115 children (96%) were assessed with the Bayley Scales of Infant and Toddler Development III and 100 children (83%) with the Infant-Toddler Social and Emotional Assessment; and 91 (86%) of 106 caregivers completed the Hospital Anxiety and Depression Scale. There were no statistically significant differences in cognitive, language, or motor composite scores between the treatment groups. However, children in the intervention group were reported by their primary caregivers to exhibit less externalizing and dysregulation behaviors and increased competence, compared with control subjects. Primary caregivers in the intervention group reported less anxiety and depression.

CONCLUSION: A preventive care program for very preterm infants and their families improved behavioral outcomes for infants and reduced anxiety and depression for primary caregivers.

DOI10.1542/peds.2009-3137
Alternate JournalPediatrics
PubMed ID20547650