Behavioural and cognitive outcomes following an early stress-reduction intervention for very preterm and extremely preterm infants

Pediatr Res. 2019 Jul;86(1):92-99. doi: 10.1038/s41390-019-0385-9. Epub 2019 Apr 9.

Abstract

Background: The landmark findings of the Mother-Infant Transaction Program (MITP) showing improved neurodevelopment of preterm infants following parent-sensitivity training delivered in the neonatal intensive care unit have not been consistently replicated. This study evaluated an MITP-type intervention in terms of neurobehavioural development to preschool age.

Methods: A randomised controlled trial involved 123 very preterm and extremely preterm infants allocated to either a parent-sensitivity intervention (PremieStart, n = 60) or to standard care (n = 63). When children were 2 and 4.5 years corrected age, parents completed the Child Behavior Checklist (CBCL). General development was assessed at 2 years with the Bayley Scales of Infant Development (Bayley-III). At 4.5 years, cognitive functioning was assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and executive functioning with the NEPSY-II.

Results: There were no significant between-group differences in behaviour problems at 2 or 4.5 years, general development at 2 years, or cognitive and executive functioning at 4.5 years.

Conclusion: Advances in the quality of neonatal intensive care may mean that MITP-type interventions now have limited additional impact on preterm infants' long-term neurobehavioural outcomes. The gestational age of infants and the exact timing of intervention may also affect its efficacy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Behavior Disorders / prevention & control
  • Child Behavior*
  • Child Development
  • Child, Preschool
  • Cognition Disorders / prevention & control
  • Cognition*
  • Executive Function
  • Female
  • Humans
  • Infant
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Intensive Care, Neonatal
  • Male
  • Mother-Child Relations / psychology
  • Mothers
  • Neuropsychological Tests
  • Parenting / psychology*
  • Psychotherapy / methods*
  • Stress, Physiological*
  • Stress, Psychological*
  • Treatment Outcome