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Flierman M, Bossen D, de Boer R, Vriend E, van Nes F, van Kaam A, Engelbert R, Jeukens-Visser M. Parents' information needs during the first year at home with their very premature born child; a qualitative study. PEC INNOVATION 2024; 4:100270. [PMID: 38495319 PMCID: PMC10940942 DOI: 10.1016/j.pecinn.2024.100270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024]
Abstract
Objective To obtain insights into parents' information needs during the first year at home with their very preterm (VP) born infant. Methods We conducted semi-structured interviews with parents of VP infants participating in a post-discharge responsive parenting intervention (TOP program). Online interviews were audiotaped and transcribed verbatim. Inductive thematic analysis was performed by two independent coders. Results Ten participants were interviewed and had various and changing information needs during the developmental trajectory of their infant. Three main themes emerged; (1) Help me understand and cope, (2) Be fully responsible for my baby, and (3) Teach me to do it myself. Available and used sources, such as the Internet, did not meet their information needs. Participants preferred their available and knowledgeable healthcare professionals for reassurance, tailored information, and practical guidance. Conclusion This study identified parents' information needs during the first year at home with their VP infant and uncovered underlying re-appearing needs to gain confidence in child-caring abilities and autonomy in decision-making about their infants' care. Innovation This study provides valuable information for healthcare professionals and eHealth developers to support parental self-efficacy during the first year after preterm birth.
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Affiliation(s)
- Monique Flierman
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Daniel Bossen
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Rosa de Boer
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Eline Vriend
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Fenna van Nes
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Anton van Kaam
- Department of Neonatology, Emma Children's Hospital, Amsterdam University Medical center, Amsterdam, the Netherlands
| | - Raoul Engelbert
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Faculty of Health, Amsterdam university of applied sciences, Amsterdam, the Netherlands
| | - Martine Jeukens-Visser
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Baraldi E, Allodi MW, Löwing K, Wadström N, Smedler AC, Örtqvist M, Westrup B, Ådén U. Parent-child interaction after home-visiting intervention for children born extremely preterm-A randomised clinical trial. Acta Paediatr 2024. [PMID: 39215963 DOI: 10.1111/apa.17399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/06/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
AIM To determine whether a strength-based home-visiting program enhances parent-child interaction during the first year at home for children born extremely preterm (gestational age < 28). METHODS A randomised controlled trial of 130 infants born extremely preterm 2018-2021 in Stockholm, allocated to either the Stockholm preterm interaction-based intervention (SPIBI) (n = 66) or an extended follow-up program (n = 64). The intervention group received ten home visits during the first year by a trained interventionist following SPIBI guidelines: an interaction-based intervention supporting sensitive parental responses to infants' signals. The primary outcome of emotional availability was assessed at 12 months corrected age (CA) using the emotional availability scales (EAS). RESULTS At 1-year CA, data were collected from 115/130 (89%) of the included children. There were no significant group differences in emotional availability at 12 months CA. A secondary analysis showed an effect modifier in families with mothers self-rated as depressed at discharge, with the outcome favouring intervention in the EAS dimension of child involvement. CONCLUSION The SPIBI had no significant main effect on emotional availability at 12 months CA. Children of self-reported depressed mothers displayed superior involvement behaviour in the intervention group, prompting further research on risk groups and potential modifications of post-discharge interventions.
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Affiliation(s)
- Erika Baraldi
- Department of Special Education, Stockholm University, Stockholm, Sweden
| | | | - Kristina Löwing
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
| | - Noni Wadström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital Neonatal Unit, Stockholm, Sweden
| | | | - Maria Örtqvist
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
| | - Björn Westrup
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Ådén
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital Neonatal Unit, Stockholm, Sweden
- Department of Bioclinical Sciences, Linköping University, Linköping, Sweden
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Malak R, Kaczmarek A, Fechner B, Samborski W, Kwiatkowski J, Komisarek O, Tuczyńska M, Tuczyńska M, Mojs E. The Importance of Follow-Up Visits for Children at Risk of Developmental Delay-A Review. Diagnostics (Basel) 2024; 14:1764. [PMID: 39202251 PMCID: PMC11354016 DOI: 10.3390/diagnostics14161764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 07/26/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024] Open
Abstract
Structured follow-up visits should be accessible for children at risk for developmental delay. Follow-up visits should include a serial neuromotor assessment in the first two years of life (e.g., 3-6, 12, 24 months corrected age), which are repeated during the transition to school. The diagnosis of neuromotor development may be prognostic for important skills later in life. The early diagnosis of a child's general movements can be helpful in planning appropriately for proper treatment and intervention. These diagnostic assessments should be conducted by qualified healthcare professionals. The evaluation of neuromotor developmental health is specified in the national guidelines and funded by either a national government or public or private healthcare insurance and based on standardized assessment scales. The aim of this study is to show what elements of follow-up visits are recommended. OBJECTIVES The group of patients for whom the structured follow-up systems are intended were children born very preterm (<32 weeks gestation) or full-term born children with severe neonatal complications. MATERIAL AND METHODS The methods for monitoring neurodevelopment include the following: The General Movements Assessment (GMA), the Ages and Stages Questionnaire (ASQ-3), the Bayley Scales of Infant and Toddler Development (BSID-4), and the Parent Report of Children's Abilities-Revised (PARCA-R). RESULTS The results of follow-up visits should be registered. CONCLUSIONS The benefits of follow-up neuromotor development assessments can be observed at school age and even in adulthood.
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Affiliation(s)
- Roksana Malak
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (B.F.); (W.S.)
| | - Ada Kaczmarek
- Department of Clinical Psychology, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (A.K.); (E.M.)
| | - Brittany Fechner
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (B.F.); (W.S.)
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (B.F.); (W.S.)
| | - Jacek Kwiatkowski
- SSC of Maxillofacial Orthopaedics and Orthodontics, University of Medical Sciences, 60-812 Poznań, Poland;
| | - Oskar Komisarek
- Department of Plastic, Reconstructive and Aesthetic Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-821 Bydgoszcz, Poland;
| | - Maria Tuczyńska
- SSC of Clinical Physiotherapy, Poznań University of Medical Sciences, 61-701 Poznań, Poland;
| | - Magdalena Tuczyńska
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznań, Poland;
| | - Ewa Mojs
- Department of Clinical Psychology, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (A.K.); (E.M.)
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Clemencic-Jones V, Trajkovski S, Fuller A, Mattock K, Stulz V. Music Therapy with Preterm Infants and Their Families after Hospital Discharge: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1018. [PMID: 39200629 PMCID: PMC11354888 DOI: 10.3390/ijerph21081018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/18/2024] [Accepted: 07/26/2024] [Indexed: 09/02/2024]
Abstract
After discharge from a neonatal unit, families of preterm infants may require therapeutic support to address challenges related to their infant/s' development, changed family circumstances, and/or parent wellbeing. This integrative review (IR) sought to examine the impact of music therapy on preterm infants and their families post-hospital discharge. A systematic search encompassing seven databases resulted in 83 citations, with six studies initially meeting the inclusion criteria. A further six studies were evaluated and selected upon their publication during the review process. Each study was assessed using the Mixed Methods Appraisal Tool (MMAT), followed by the identification of major themes and sub-themes. Our results suggest that music therapy contributed to creating supportive physical and metaphorical environments for preterm infants and their families, in which they could acquire essential skills, tools, and resources for fostering communication and connection with one another. Preterm infants and toddlers may have also enhanced their developmental skills through music therapy sessions post-discharge. Further investigation into the impact of music therapy on preterm infants and their caregivers at different timepoints after hospital discharge is recommended, as well as a comparison of individual and group music therapy outcomes on infant development and parent health. Future research should include a broader spectrum of family members, along with caregivers from diverse family structures and gender identities, reflecting practices already established in some clinical settings.
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Affiliation(s)
- Verena Clemencic-Jones
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
| | - Suza Trajkovski
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
| | - Allison Fuller
- School of Humanities and Communication Arts, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
| | - Karen Mattock
- School of Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia;
| | - Virginia Stulz
- School of Nursing and Midwifery, University of Canberra, Bruce, ACT 2617, Australia;
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Oh WO, Heo YJ. Early Parenting Interventions to Enhance Development in Infants and Children Born Prematurely: A Systematic Review and Meta-Analysis. J Pediatr Health Care 2024:S0891-5245(24)00148-2. [PMID: 39023458 DOI: 10.1016/j.pedhc.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 06/08/2024] [Accepted: 06/08/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION Parenting interventions have the potential to become effective strategies for improving the developmental trajectories of infants and children born prematurely. However, the effectiveness of parenting interventions is not well understood. METHODS A literature search was conducted in five databases. A total of 24 studies involving 3,636 participants were included for review. RESULTS The results showed a significant effect in cognition, language, motor development, and behavioral problems of children born prematurely. Parenting stress, anxiety, and interactive behaviors showed significant effect size. DISCUSSION This review focuses on interventions that employ scaffolding parenting strategies to enhance the development of children born prematurely. Efforts should continue to empower parents through effective and sustainable parenting interventions to improve the quality of life of preterm children.
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Affiliation(s)
- Won-Oak Oh
- Won-Oak Oh, Professor and Yoo-Jin Heo, Post-Doctoral Researcher, College of Nursing, Korea University, Seoul, South Korea
| | - Yoo-Jin Heo
- Won-Oak Oh, Professor and Yoo-Jin Heo, Post-Doctoral Researcher, College of Nursing, Korea University, Seoul, South Korea.
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6
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Jang YH, Ham J, Kasani PH, Kim H, Lee JY, Lee GY, Han TH, Kim BN, Lee HJ. Predicting 2-year neurodevelopmental outcomes in preterm infants using multimodal structural brain magnetic resonance imaging with local connectivity. Sci Rep 2024; 14:9331. [PMID: 38653988 DOI: 10.1038/s41598-024-58682-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
The neurodevelopmental outcomes of preterm infants can be stratified based on the level of prematurity. We explored brain structural networks in extremely preterm (EP; < 28 weeks of gestation) and very-to-late (V-LP; ≥ 28 and < 37 weeks of gestation) preterm infants at term-equivalent age to predict 2-year neurodevelopmental outcomes. Using MRI and diffusion MRI on 62 EP and 131 V-LP infants, we built a multimodal feature set for volumetric and structural network analysis. We employed linear and nonlinear machine learning models to predict the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) scores, assessing predictive accuracy and feature importance. Our findings revealed that models incorporating local connectivity features demonstrated high predictive performance for BSID-III subsets in preterm infants. Specifically, for cognitive scores in preterm (variance explained, 17%) and V-LP infants (variance explained, 17%), and for motor scores in EP infants (variance explained, 15%), models with local connectivity features outperformed others. Additionally, a model using only local connectivity features effectively predicted language scores in preterm infants (variance explained, 15%). This study underscores the value of multimodal feature sets, particularly local connectivity, in predicting neurodevelopmental outcomes, highlighting the utility of machine learning in understanding microstructural changes and their implications for early intervention.
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Affiliation(s)
- Yong Hun Jang
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Jusung Ham
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, 52242, USA
| | - Payam Hosseinzadeh Kasani
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Hyuna Kim
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Joo Young Lee
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Gang Yi Lee
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Tae Hwan Han
- Division of Neurology, Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Division of Children and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea.
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7
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Msall ME, Lagatta JM, Bora S. Optimizing trajectories of social adaptive competencies after extreme prematurity during the first 1000 days. Semin Fetal Neonatal Med 2024; 29:101531. [PMID: 38632009 PMCID: PMC11156543 DOI: 10.1016/j.siny.2024.101531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Over 75% of surviving extremely preterm infants do not have major neurodevelopmental disabilities; however, more than half face difficulties with communication, coordination, attention, learning, social, and executive function abilities. These "minor" challenges can have a negative impact on educational and social outcomes, resulting in physical, behavioral, and social health problems in adulthood. We will review assessment tools for social-emotional and adaptive functional skills in early childhood as these determine family and early childhood supports. We highlight bronchopulmonary dysplasia as an example of the critical intersections of parental wellbeing, medical and developmental adaptive trajectories in infancy and early childhood, and partnerships between child neurologists and community medical and developmental professionals. We examine studies of engaging parents to promote developmental trajectories, with a focus on supporting parent-child interactions that underlie communication, social-adaptive behaviors, and learning in the first 1000 days of life. Recommendations for neurodevelopmental surveillance and screening of extremely preterm infants can also be applied to infants with other risk factors for altered neurodevelopment.
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Affiliation(s)
- Michael E Msall
- Department of Pediatrics, Section of Developmental and Behavioral Pediatrics and Kennedy Research Center on Intellectual and Developmental Disabilities, University of Chicago Medicine, Chicago, IL, USA.
| | - Joanne M Lagatta
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Samudragupta Bora
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Suir I, Boonzaaijer M, Oudgenoeg-Paz O, van Schie PEM, Nuysink J, Jongmans MJ. Parental Beliefs About the Motor Development of Dutch Infants Born Very Preterm: A Cohort Study. Pediatr Phys Ther 2024; 36:95-103. [PMID: 38227754 DOI: 10.1097/pep.0000000000001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
PURPOSE To explore the influence of preterm birth on parental beliefs about gross motor development and parents' supportive role in infants' motor development. METHODS Prospective cohort study: Parents of infants born very preterm (VPT) (gestation ≤32 weeks, birth weight <1500 g, without perinatal complications) and parents of healthy infants born full-term (FT) completed the Parental Beliefs on Motor Development questionnaire. RESULTS Questionnaires from 37 parents of infants born VPT, aged 3.5 to 7.5 months (corrected), and 110 parents of infants born FT, aged 3.5 months, were analyzed. Parents of infants born VPT believed stimulating motor development to be more important than parents of infants born FT (F = 5.22; P = .024; ηp2 = 0.035). Most parents of infants born VPT (82.4%) and FT (85.2%) acknowledged their role in supporting motor development. More parents of infants born VPT (41.2% vs 12.0%) believed they should follow their infant's natural developmental pace. CONCLUSION Knowledge of parental beliefs and parents' supporting role in motor development is relevant for tailoring pediatric physiotherapists' interventions with families.
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Affiliation(s)
- Imke Suir
- Research Group Lifestyle and Health (Mss Suir, Boonzaaijer, and Nuysink), Research Centre Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, the Netherlands; Department of Pedagogical and Educational Sciences (Mss Suir, Oudgenoeg-Paz, and Jongmans), Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, the Netherlands; Department of Neonatology (Mss Boonzaaijer and Jongmans), Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Rehabilitation Medicine (Ms van Schie), Amsterdam UMC, location VU University Medical Center, Amsterdam, the Netherlands
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9
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Jeukens-Visser M, Leemhuis A, Flierman M. Response to "Scoping review of interventions to support families with preterm infants post-NICU discharge" by Griffith et. al published in Journal of Pediatric Nursing (). J Pediatr Nurs 2023; 72:207-208. [PMID: 37142494 DOI: 10.1016/j.pedn.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Martine Jeukens-Visser
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands.
| | - Aleid Leemhuis
- Amsterdam Reproduction and Development, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Neonatology, Meibergdreef 9, Amsterdam, the Netherlands
| | - Monique Flierman
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands
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Bijlsma A, Beunders VA, Dorrepaal DJ, Joosten KF, van Beijsterveldt IA, Dudink J, Reiss IK, Hokken-Koelega AC, Vermeulen MJ. Sleep and 24-hour rhythm characteristics in preschool children born very preterm and full term. J Clin Sleep Med 2023; 19:685-693. [PMID: 36661086 PMCID: PMC10071387 DOI: 10.5664/jcsm.10408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 01/21/2023]
Abstract
STUDY OBJECTIVES Sleep impacts the quality of life and is associated with cardiometabolic and neurocognitive outcomes. Little is known about the sleep of preterm-born children at preschool age. We, therefore, studied sleep and 24-hour rhythms of preschool children born very preterm compared with full-term children. METHODS This was a prospective cohort study comparing sleep quality and quantity of children born very preterm (gestational age [GA] < 30 weeks) with full-term children at the (corrected) age of 3 years, using (1) 2 parent-reported questionnaires (Brief Infant Sleep Questionnaire and The Munich Chronotype Questionnaire) and (2) at least 3 days of triaxial wrist actigraphy combined with sleep diary. We performed regression analyses with adjustment for sex (corrected), age, and birth weight standard deviation (SD) score. RESULTS Ninety-seven very-preterm-born (median GA 27+5; interquartile range 26 + 3;29 + 0 weeks) and 92 full-term children (GA 39 + 3; 38 + 4;40 + 4 weeks) were included. Sleep problems and other reported sleep parameters were not different between groups. As measured with actigraphy, sleep and 24-hour rhythm were similar between groups, except for very-preterm born children waking up 21 minutes (4;38) minutes later than full-term children (adjusted P = .001). CONCLUSIONS Based on parent reports and actigraphy, very-preterm-born children sleep quite similar to full-term controls at the corrected age of 3 years. Reported sleep problems were not different between groups. Actigraphy data suggest that preterm-born children may wake up later than children born full term. Further studies are needed to explore how sleep relates to cardiometabolic and neurodevelopmental outcomes after preterm birth and whether early interventions are useful to optimize 24-hour rhythm and sleep. CITATION Bijlsma A, Beunders VAA, Dorrepaal DJ, et al. Sleep and 24-hour rhythm characteristics in preschool children born very preterm and full term. J Clin Sleep Med. 2023;19(4):685-693.
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Affiliation(s)
- Alja Bijlsma
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Victoria A.A. Beunders
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Demi J. Dorrepaal
- Subdivision of Endocrinology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen F.M. Joosten
- Department of Pediatrics, Intensive Care Unit, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Inge A.L.P. van Beijsterveldt
- Subdivision of Endocrinology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Irwin K.M. Reiss
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anita C.S. Hokken-Koelega
- Subdivision of Endocrinology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marijn J. Vermeulen
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
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11
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Halbmeijer NM, Jeukens-Visser M, Onland W, Flierman M, van Kaam AH, Leemhuis A. Neurodevelopmental Outcomes at Two Years' Corrected Age of Very Preterm Infants After Implementation of a Post-discharge Responsive Parenting Intervention Program (TOP program). J Pediatr 2023:113381. [PMID: 36889631 DOI: 10.1016/j.jpeds.2023.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVE To compare neurodevelopmental outcomes at two years corrected age (CA) between infants born very preterm (VP) who did or did not receive a post-discharge responsive parenting intervention (TOP program) between discharge home and 12 months CA. STUDY DESIGN The Systemic Hydrocortisone to Prevent Bronchopulmonary Dysplasia (SToP-BPD) study showed no differences between treatment groups in motor and cognitive development using the Dutch Bayley Scales of Infant Development, and behavior using the Child Behavior Check List at two years CA. During its study period, the TOP program was gradually scaled up nationwide in the same population, providing an opportunity to evaluate the effect of this program on neurodevelopmental outcome, after adjusting for baseline differences. RESULTS Among 262 surviving VP infants in the SToP-BPD study, 35% received the TOP program. Infants in the TOP group had a significantly lower incidence of a cognitive score <85 (20.3% vs. 35.2%; adjusted absolute risk reduction -14.1% [95% CI -27.2 to -1.1]; p=0.03), and a significantly higher mean cognitive score (96.7 ±13.8), compared with the non-TOP group (92.0 ±17.5; crude mean difference 4.7 [95% CI 0.3 to 9.2]; p=0.03). No significant differences were found on motor scores. For behavior problems, a small but statistically significant effect for anxious/depressive problems was found in the TOP group (50.5 vs. 51.2; p=0.02). CONCLUSIONS VP infants supported by the TOP program from discharge until 12 months CA had better cognitive function at two years CA. This study demonstrates a sustained positive effect of the TOP program in VP infants.
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Affiliation(s)
- Nienke M Halbmeijer
- Amsterdam UMC, University of Amsterdam, Department of Neonatology, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Martine Jeukens-Visser
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Meibergdreef 9, Amsterdam, The Netherlands
| | - Wes Onland
- Amsterdam UMC, University of Amsterdam, Department of Neonatology, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Monique Flierman
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Meibergdreef 9, Amsterdam, The Netherlands
| | - Anton H van Kaam
- Amsterdam UMC, University of Amsterdam, Department of Neonatology, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Aleid Leemhuis
- Amsterdam UMC, University of Amsterdam, Department of Neonatology, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
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12
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Suir I, Boonzaaijer M, Oudgenoeg-Paz O, Westers P, de Vries LS, van der Net J, Nuysink J, Jongmans MJ. Modeling gross motor developmental curves of extremely and very preterm infants using the AIMS home-video method. Early Hum Dev 2022; 175:105695. [PMID: 36459886 DOI: 10.1016/j.earlhumdev.2022.105695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Motor development is one of the first signals to identify whether an infant is developing well. For very preterm (VPT) infants without severe perinatal complications, little is known about their motor developmental curves. AIMS Explore gross motor developmental curves from 3 until 18 months corrected age (CA) of VPT infants, and related factors. Explore whether separate profiles can be distinguished and compare these to profiles of Dutch term-born infants. STUDY DESIGN Prospective cohort study with parents repeatedly recording their infant, using the Alberta Infant Motor Scale (AIMS) home-video method, from 3 to 18 months CA. SUBJECTS Forty-two Dutch infants born ≤32.0 weeks gestational age and/or with a birthweight (BW) of <1500 g without severe perinatal complications. OUTCOME MEASURES Gross motor development measured with the AIMS. RESULTS In total 208 assessments were analyzed, with 27 infants ≥five assessments, 12 with <four, and three with one assessment. Sigmoid-shaped gross motor curves show unidirectional growth and variability. No infant or parental factors significantly influenced motor development, although a trend was seen for the model where lower BW, five-minute Apgar score <7, and Dutch native-speaking parents were associated with slower motor development. Three motor developmental profiles of VPT infants were identified, early developers, gradual developers, and late bloomers, which until 12 months CA are comparable in shape and speed to profiles of Dutch term-born infants. CONCLUSIONS VPT infants show great intra- and interindividual variability in gross motor development, with three motor profiles being distinguished. From 12 months CA onwards, VPT infants appear to develop at a slower pace. With some caution, classifying infants into motor developmental profiles may assist clinical decision-making.
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Affiliation(s)
- I Suir
- Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, the Netherlands; Utrecht University, Faculty of Social and Behavioral Sciences, Department of Pedagogical and Educational Sciences, Utrecht, the Netherlands.
| | - M Boonzaaijer
- Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, the Netherlands; University Medical Center Utrecht, Wilhelmina Children's Hospital, Department of Neonatology, Utrecht, the Netherlands
| | - O Oudgenoeg-Paz
- University Medical Center Utrecht, Wilhelmina Children's Hospital, Department of Neonatology, Utrecht, the Netherlands
| | - P Westers
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - L S de Vries
- University Medical Center Utrecht, Wilhelmina Children's Hospital, Department of Neonatology, Utrecht, the Netherlands
| | - J van der Net
- University Medical Centre Utrecht, Wilhelmina Children's Hospital, Department of Child Development, Exercise and Physical Literacy, Utrecht, the Netherlands
| | - J Nuysink
- Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, the Netherlands
| | - M J Jongmans
- Utrecht University, Faculty of Social and Behavioral Sciences, Department of Pedagogical and Educational Sciences, Utrecht, the Netherlands; University Medical Center Utrecht, Wilhelmina Children's Hospital, Department of Neonatology, Utrecht, the Netherlands
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13
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Lean RE. Sensitive Parenting: A Key Moderator of Neonatal Cortical Dysmaturation and Neurodevelopmental Outcomes in Children Born Very Preterm. Biol Psychiatry 2022; 92:609-611. [PMID: 36137704 DOI: 10.1016/j.biopsych.2022.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Rachel E Lean
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
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14
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van Boven MR, Henke CE, Leemhuis AG, Hoogendoorn M, van Kaam AH, Königs M, Oosterlaan J. Machine Learning Prediction Models for Neurodevelopmental Outcome After Preterm Birth: A Scoping Review and New Machine Learning Evaluation Framework. Pediatrics 2022; 150:188249. [PMID: 35670123 DOI: 10.1542/peds.2021-056052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Outcome prediction of preterm birth is important for neonatal care, yet prediction performance using conventional statistical models remains insufficient. Machine learning has a high potential for complex outcome prediction. In this scoping review, we provide an overview of the current applications of machine learning models in the prediction of neurodevelopmental outcomes in preterm infants, assess the quality of the developed models, and provide guidance for future application of machine learning models to predict neurodevelopmental outcomes of preterm infants. METHODS A systematic search was performed using PubMed. Studies were included if they reported on neurodevelopmental outcome prediction in preterm infants using predictors from the neonatal period and applying machine learning techniques. Data extraction and quality assessment were independently performed by 2 reviewers. RESULTS Fourteen studies were included, focusing mainly on very or extreme preterm infants, predicting neurodevelopmental outcome before age 3 years, and mostly assessing outcomes using the Bayley Scales of Infant Development. Predictors were most often based on MRI. The most prevalent machine learning techniques included linear regression and neural networks. None of the studies met all newly developed quality assessment criteria. Studies least prone to inflated performance showed promising results, with areas under the curve up to 0.86 for classification and R2 values up to 91% in continuous prediction. A limitation was that only 1 data source was used for the literature search. CONCLUSIONS Studies least prone to inflated prediction results are the most promising. The provided evaluation framework may contribute to improved quality of future machine learning models.
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Affiliation(s)
- Menne R van Boven
- Departments of Neonatology.,Pediatrics, Follow-Me Program, Emma Neuroscience Group, and Amsterdam Reproduction and Development
| | - Celina E Henke
- Pediatrics, Follow-Me Program, Emma Neuroscience Group, and Amsterdam Reproduction and Development.,Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Aleid G Leemhuis
- Departments of Neonatology.,Pediatrics, Follow-Me Program, Emma Neuroscience Group, and Amsterdam Reproduction and Development
| | - Mark Hoogendoorn
- Faculty of Science, Quantitative Data Analytics Group, Department Computer Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Anton H van Kaam
- Departments of Neonatology.,Pediatrics, Follow-Me Program, Emma Neuroscience Group, and Amsterdam Reproduction and Development
| | - Marsh Königs
- Pediatrics, Follow-Me Program, Emma Neuroscience Group, and Amsterdam Reproduction and Development
| | - Jaap Oosterlaan
- Pediatrics, Follow-Me Program, Emma Neuroscience Group, and Amsterdam Reproduction and Development
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15
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Suir I, Oosterhaven J, Boonzaaijer M, Nuysink J, Jongmans M. The AIMS home-video method: parental experiences and appraisal for use in neonatal follow-up clinics. BMC Pediatr 2022; 22:338. [PMID: 35690764 PMCID: PMC9187888 DOI: 10.1186/s12887-022-03398-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 05/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background In The Netherlands, prematurely born infants and their parents are offered regular developmental check-ups in a hospital setting. In line with providing healthcare at distance, the use of video footage showing the infant’s behavior and movements, taken by parents at home and assessed by professionals online, might be a fruitful future practice. The focus of this study was to gain insight into parental experiences with the Alberta Infant Motor Scale home-video method and their appraisal of its applicability for use in an outpatient neonatal follow-up clinic. Method A qualitative descriptive study among parents of healthy extremely or very premature infants (GA 26.2–31.5 weeks) participating in a longitudinal study of motor development between 3–18 months corrected age. Ten semi-structured interviews were conducted and transcribed verbatim. Data was analyzed independently. Inductive content analysis was performed following the process of the AIMS home-video method. Results Parents appraised the AIMS home-video method as manageable and fun to do. Instructions, instruction film, and checklists were clear. Transferring the video footage from their phone to their computer and uploading it to the web portal was sometimes time-consuming. Parents gained a better awareness of their infant’s motor development and found the provided feedback a confirmation of what they already thought about their infant’s development and was reassuring that their child was doing well. First-time parents seemed more uncertain and had a greater need for information about (motor) development, but on the other hand, also had confidence in their child. All parents thought that home-videos can be an addition to follow-up visits, but cannot replace (all) visits. It may be an opportunity to reduce the frequency of hospital visits, while still having their infant monitored. Conclusion Parents appraised the AIMS home-video method positively and are of the opinion that home-videos can be of added value in monitoring infants at risk in neonatal follow-up additional to hospital visits. In future research a user-friendly application and/or platform to exchange video footage safely between parents and professionals should be developed with all possible stakeholders involved and implementation should be explored. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03398-9.
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Affiliation(s)
- I Suir
- Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, The Netherlands. .,Faculty of Social and Behavioural Sciences, Department of Pedagogical and Educational Sciences, Utrecht University, Utrecht, The Netherlands.
| | - J Oosterhaven
- Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, The Netherlands
| | - M Boonzaaijer
- Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, The Netherlands.,Faculty of Social and Behavioural Sciences, Department of Pedagogical and Educational Sciences, Utrecht University, Utrecht, The Netherlands.,Department of Neonatology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - J Nuysink
- Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, The Netherlands
| | - M Jongmans
- Faculty of Social and Behavioural Sciences, Department of Pedagogical and Educational Sciences, Utrecht University, Utrecht, The Netherlands.,Department of Neonatology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands
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Schuetz Haemmerli N, Stoffel L, Schmitt KU, Khan J, Humpl T, Nelle M, Cignacco E. Enhancing Parents' Well-Being after Preterm Birth-A Qualitative Evaluation of the "Transition to Home" Model of Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074309. [PMID: 35409993 PMCID: PMC8998674 DOI: 10.3390/ijerph19074309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 01/03/2023]
Abstract
There are few programs available aimed at preventing short- and long-term negative consequences after preterm birth and covering the entire care continuum. The “Transition to Home (TtH)” model is such a program, offering structured, individual support for families with preterm infants before and after hospital discharge. This study gathers and examines the parents’ views of receiving support from an interprofessional team under the TtH model of care during hospitalization and after discharge. Using a qualitative explorative design, 39 semi-structured interviews with parents were analyzed thematically. From this analysis, three main themes were identified: (1) TtH and the relevance of continuity of care; (2) Enhancement of parents’ autonomy and self-confidence; (3) Perception of interprofessional collaboration. Within these themes, the most relevant aspects identified were continuity of care and the appointment of a designated health care professional to anchor the entire care continuum. Emotional support complemented by non-medical approaches, along with strength-based and family resource-oriented communication, also emerged as key aspects. Continuous, family-centered care and well-organized interprofessional collaboration promote the well-being of the family after a premature birth. If the aspects identified in this study are applied, the transition from hospital to home will be smoothened for the benefit of affected families.
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Affiliation(s)
- Natascha Schuetz Haemmerli
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
- Correspondence:
| | - Liliane Stoffel
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Kai-Uwe Schmitt
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
- Insel Gruppe, Bern University Hospital, 3010 Bern, Switzerland
| | - Jeannine Khan
- Kantonale Schule für Berufsbildung, 5001 Aarau, Switzerland;
| | - Tilman Humpl
- Tilman Humpl, Department of Paediatrics, St. Elisabethen-Krankenhaus, Kliniken des Landeskreises Lörrach, 79539 Lörrach, Germany;
| | - Mathias Nelle
- Mathias Nelle, Children’s Hospital, Kreiskliniken Böblingen, 71302 Böblingen, Germany;
| | - Eva Cignacco
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
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Vriend E, Leemhuis A, Flierman M, Schie P, Nollet F, Jeukens‐Visser M. Mental health monitoring in parents after very preterm birth. Acta Paediatr 2021; 110:2984-2993. [PMID: 34375472 PMCID: PMC9291782 DOI: 10.1111/apa.16064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/09/2021] [Accepted: 08/06/2021] [Indexed: 11/28/2022]
Abstract
AIM To evaluate parental mental health monitoring during follow-up care for very preterm (VPT) infants, describe symptoms of anxiety and depression and risk factors for mothers and fathers at 1 and 12 months of corrected age. METHODS Parents completed the Hospital Anxiety and Depression Scale (HADS). Psychological symptoms and risk factors were analysed within and between mothers and fathers. RESULTS In 4 years, the monitoring reached 1260 (48%) families. Of these, 693 mothers and 340 fathers (300 couples) completed the HADS twice. At 1 month, 22% and 15% of the mothers and 10% and 9% of the fathers, respectively, reported elevated symptoms of anxiety and depression. At 12 months, these rates were significantly reduced to 14% and 9% for mothers and 5% and 4% for fathers respectively. Within couples, anxiety and depression were positively associated. At 12 months, in 20% of the couples, one or both parents reported elevated symptoms. Risk factors were length of hospital stay, migration background, educational level and employment status. CONCLUSION The mental health of parents of VPT infants improved, but elevated symptoms were still observed in 17% of included families after one year. Acknowledging and remediating parental mental health remain essential during follow-up care.
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Affiliation(s)
- Eline Vriend
- Department of Rehabilitation Medicine, Amsterdam Reproduction and Development Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Aleid Leemhuis
- Department of Neonatology, Amsterdam Reproduction and Development Emma Children's Hospital Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Monique Flierman
- Department of Rehabilitation Medicine, Amsterdam Reproduction and Development Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Petra Schie
- Department of Rehabilitation Medicine, Amsterdam Reproduction and Development Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Frans Nollet
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
| | - Martine Jeukens‐Visser
- Department of Rehabilitation Medicine, Amsterdam Reproduction and Development Amsterdam UMC University of Amsterdam Amsterdam the Netherlands
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Jeukens-Visser M, Koldewijn K, van Wassenaer-Leemhuis AG, Flierman M, Nollet F, Wolf MJ. Development and nationwide implementation of a postdischarge responsive parenting intervention program for very preterm born children: The TOP program. Infant Ment Health J 2020; 42:423-437. [PMID: 33336859 PMCID: PMC8247046 DOI: 10.1002/imhj.21902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A previous randomized controlled trial has suggested the effectiveness of a Dutch postdischarge responsive parenting program for very preterm (VPT) infants, indicating that nationwide implementation was justified. This paper describes the development and nationwide implementation of the intervention, known as the TOP program, which consisted of three phases. In the preparation phase (2006-2010), a theory of change and the structure of the TOP program were developed, and funding for phase two, based on a positive Business Case, was obtained. In the pilot implementation phase (2010-2014), intervention strategies were developed for a real-world setting, capacity and adoption were increased, systematic evaluations were incorporated, and sustained funding was obtained. In the full-implementation phase (2014-2019), all Dutch Healthcare Insurers reimbursed the TOP program, enabling VPT infants to participate in the program without charge. By 2018, the number of interventionists that provided the TOP program had increased from 37 to 91, and all level III hospitals and 65% of regional hospitals in the Netherlands referred VPT infants. Currently, the program reaches 70% of the Dutch target population and parental satisfaction with the TOP program is high. After a 12-year implementation period, the TOP program forms part of routine care in the Netherlands.
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Affiliation(s)
- Martine Jeukens-Visser
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Karen Koldewijn
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Aleid G van Wassenaer-Leemhuis
- Emma Children's Hospital, Amsterdam UMC, Department of Neonatology, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique Flierman
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Frans Nollet
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Marie-Jeanne Wolf
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
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