Family-Centered Care Enhanced Neonatal Neurophysiological Function in Preterm Infants: Randomized Controlled Trial

Yen-Ting Yu; Wan-Chi Huang; Wu-Shiun Hsieh; Jui-Hsing Chang; Chyi-Her Lin; Shulan Hsieh; Lu Lu; Nai-Jia Yao; Pi-Chuan Fan; Chia-Lin Lee; Yu-Kang Tu; Suh-Fang Jeng

doi:10.1093/ptj/pzz120

Family-Centered Care Enhanced Neonatal Neurophysiological Function in Preterm Infants: Randomized Controlled Trial

Phys Ther. 2019 Dec 16;99(12):1690-1702. doi: 10.1093/ptj/pzz120.

Authors

Yen-Ting Yu¹, Wan-Chi Huang², Wu-Shiun Hsieh³, Jui-Hsing Chang⁴, Chyi-Her Lin⁵, Shulan Hsieh⁶, Lu Lu⁷, Nai-Jia Yao⁸, Pi-Chuan Fan⁹, Chia-Lin Lee¹⁰, Yu-Kang Tu¹¹, Suh-Fang Jeng¹²

Affiliations

¹ Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; and Department of Psychology, National Cheng Kung University, Tainan, Taiwan.
² Institute of Physical Therapy, College of Medicine, National Taiwan University; and Department of Physical Medicine and Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
³ Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan.
⁵ Department of Psychology, National Cheng Kung University.
⁶ Department of Psychology, National Cheng Kung University; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University; and Department and Institute of Public Health, National Cheng Kung University.
⁷ Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital.
⁸ Institute of Physical Therapy, College of Medicine, National Taiwan University.
⁹ Department of Pediatrics, National Taiwan University Hospital.
¹⁰ Institute of Linguistics, National Taiwan University.
¹¹ Institute of Epidemiology, College of Public Health, National Taiwan University.
¹² Institute of Physical Therapy, College of Medicine, National Taiwan University, Floor 3, No 17, Xu-Zhou Road, 100 Taipei, Taiwan; and Physical Therapy Center, National Taiwan University Hospital.

PMID: 31504897
DOI: 10.1093/ptj/pzz120

Abstract

Background: Family-centered intervention for preterm infants has shown short- to medium-term developmental benefits; however, the neurological effects of intervention have rarely been explored.

Objective: The objectives of this study were to examine the effect of a family-centered intervention program (FCIP) on neurophysiological functions in preterm infants with very low birth weight (VLBW; birth weight of < 1500 g) in Taiwan, to compare the effect of the FCIP with that of a usual-care program (UCP), and to explore the FCIP-induced changes in neurobehavioral and neurophysiological functions.

Design: This was a multicenter, single-blind randomized controlled trial.

Setting: The study took place in 3 medical centers in northern and southern Taiwan.

Participants: Two hundred fifty-one preterm infants with VLBW were included.

Intervention: The FCIP group received a family-centered intervention and the UCP group received standard care during hospitalization.

Measurements: Infants were assessed in terms of neurobehavioral performance using the Neonatal Neurobehavioral Examination-Chinese version, and their neurophysiological function was assessed using electroencephalography/event-related potentials during sleep and during an auditory oddball task during the neonatal period.

Results: The FCIP promoted more mature neurophysiological function than the UCP, including greater negative mean amplitudes of mismatch negativities in the left frontal region in the oddball task in all infants, lower intrahemispheric prefrontal-central coherence during sleep in infants who were small for gestational age, and higher interhemispheric frontal coherence during sleep in those who were appropriate for gestational age. Furthermore, interhemispheric coherence was positively associated with the total neurobehavioral score in preterm infants who were appropriate for gestational age (r = 0.20).

Limitations: The fact that more parental adherence strategies were used in the FCIP group than in the UCP group might have favored the intervention effect in this study.

Conclusions: Family-centered intervention facilitates short-term neurophysiological maturation in preterm infants with VLBW in Taiwan.

Trial registration: ClinicalTrials.gov NCT01807533.

Publication types

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

MeSH terms

Early Medical Intervention / methods*
Electroencephalography
Evoked Potentials / physiology
Family*
Humans
Infant Behavior
Infant, Newborn
Infant, Premature / physiology*
Infant, Very Low Birth Weight / physiology*
Motor Activity / physiology
Neurophysiological Monitoring / methods
Observer Variation
Patient-Centered Care / methods*
Reflex / physiology
Single-Blind Method
Sleep / physiology
Taiwan

Associated data

ClinicalTrials.gov/NCT01807533