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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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Bernabe-Zuñiga JE, Rodriguez-Lucenilla MI, Alias-Castillo AJ, Rueda-Ruzafa L, Roman P, Del Mar Sanchez-Joya M. Early interventions with parental participation and their implications on the neurodevelopment of premature children: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02528-1. [PMID: 39028424 DOI: 10.1007/s00787-024-02528-1] [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: 03/27/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
The occurrence of preterm birth is correlated with the potential emergence of disabilities in children. Early intervention programs are designed to promote better developmental outcomes. These interventions employ family-centered methodologies, wherein parents are instructed to facilitate neurodevelopment, thereby promoting heightened involvement of the child in their daily activities. The objective of this investigation was to evaluate the efficacy of early family-based interventions on motor, cognitive, and language development. A systematic review and meta-analysis was conducted utilizing the databases PubMed, Medline, PEDro, Scopus, CINAHL Complete, SciELO, and Open Grey. The search terms utilized included NDT (neuro-developmental treatment), Bobath, neurodevelopmental therapy, parents administered, family administered, physical therapy modalities, early intervention (educational), early intervention, premature infant, preterm, and premature. Randomized clinical trials and observational studies written in English or Spanish were taken into consideration. The initial search resulted in 420 articles. After removing duplicates and applying the selection criteria, 12 articles were selected for the systematic review and 5 articles were selected for the meta-analysis. The meta-analysis revealed a significant association between early intervention and enhanced cognitive function (p = 0.01) in this study. Additionally, the meta-analysis indicated improvements resulting from early family-based intervention (p = 0.02) in motor function. Early motor interventions that emphasize parent involvement and education in neurodevelopment show significant outcomes in motor and cognitive areas at 2 years of age in very premature or extremely premature infants. However, inconclusive effects have been found in the language area, which is the least studied domain. Due to the methodological heterogeneity observed, further research is needed to establish conclusive decisions regarding the administration of these interventions and the determination of key evaluation periods.
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Affiliation(s)
- Jose Enrique Bernabe-Zuñiga
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusia, 04120, Spain
| | | | - Antonio Javier Alias-Castillo
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusia, 04120, Spain
| | - Lola Rueda-Ruzafa
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusia, 04120, Spain.
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, 04120, Spain.
- Health Research Center CEINSA, University of Almería, Andalusía, 04120, Spain.
| | - Pablo Roman
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusia, 04120, Spain
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, 04120, Spain
- Health Research Center CEINSA, University of Almería, Andalusía, 04120, Spain
| | - Maria Del Mar Sanchez-Joya
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusia, 04120, Spain
- Health Research Center CEINSA, University of Almería, Andalusía, 04120, Spain
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农 绍, 余 卫, 李 翠, 周 晓. [Preventive early intervention strategies for neurodevelopmental disorders of high-risk infants]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:297-301. [PMID: 38557383 PMCID: PMC10986381 DOI: 10.7499/j.issn.1008-8830.2310107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/16/2024] [Indexed: 04/04/2024]
Abstract
Neurodevelopmental disorders in children have become a significant global public health concern, impacting child health worldwide. In China, the current intervention model for high-risk infants involves early diagnosis and early treatment. However, in recent years, overseas studies have explored novel preventive early intervention strategies for neurodevelopmental disorders in high-risk infants, achieving promising results. This article provides a comprehensive review of the optimal timing, methods, and intervention models of the preventive early intervention strategies for neurodevelopmental disorders in high-risk infants. The aim is to enhance the awareness and knowledge of healthcare professionals regarding preventive early intervention strategies for neurodevelopmental disorders in high-risk infants, facilitate clinical research and application of such interventions in China, and ultimately reduce the incidence of neurodevelopmental disorders in this high-risk population.
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Affiliation(s)
| | - 卫红 余
- 云南省文山壮族苗族自治州人民医院新生儿科,云南文山663000
| | - 翠红 李
- 云南省文山壮族苗族自治州人民医院新生儿科,云南文山663000
| | - 晓光 周
- 中山大学附属第八医院新生儿科, 广东深圳518033
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Ponnapakkam A, Carr NR, Comstock BA, Perez K, O'Shea TM, Tolia VN, Clark RH, Heagerty PJ, Juul SE, Ahmad KA. Factors Associated with Outpatient Therapy Utilization in Extremely Preterm Infants. Am J Perinatol 2024; 41:458-469. [PMID: 34753183 DOI: 10.1055/a-1692-0544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Factors influencing utilization of outpatient interventional therapies for extremely low gestational age newborns (ELGANs) after discharge remain poorly characterized, despite a significant risk of neurodevelopmental impairment. We sought to assess the effects of maternal, infant, and environmental characteristics on outpatient therapy utilization in the first 2 years after discharge using data from the Preterm Erythropoietin Neuroprotection (PENUT) Trial. STUDY DESIGN This is a secondary analysis of 818, 24 to 27 weeks gestation infants enrolled in the PENUT trial who survived through discharge and completed at least one follow-up call or in-person visit between 4 and 24 months of age. Utilization of a state early intervention (EI) program, physical therapy (PT), occupational therapy (OT), and speech therapy (ST) was recorded. Odds ratios and cumulative frequency curves for resource utilization were calculated for patient characteristics adjusting for gestational age, treatment group, and birth weight. RESULTS EI was not accessed by 37% of infants, and 18% did not use any service (PT/OT/ST/EI). Infants diagnosed with severe morbidities (intraventricular hemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia, necrotizing enterocolitis), discharged with home oxygen, or with gastrostomy placement experienced increased utilization of PT, OT, and ST compared with peers. However, substantial variation in service utilization occurred by the state of enrollment and selected maternal characteristics. CONCLUSIONS ELGANs with severe medical comorbidities are more likely to utilize services after discharge. Therapy utilization may be impacted by maternal characteristics and state of enrollment. Outpatient therapy services remain significantly underutilized in this high-risk cohort. Further research is required to characterize and optimize the utilization of therapy services following NICU discharge of ELGANs. KEY POINTS · Outpatient therapy is underutilized in ELGANs.. · Medical comorbidities may impact therapy use.. · Maternal characteristics may impact therapy use.. · State of enrollment may impact therapy use..
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Affiliation(s)
- Adharsh Ponnapakkam
- Department of Pediatrics, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas
| | - Nicholas R Carr
- Department of Pediatrics, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Bryan A Comstock
- Center for Biomedical Statistics, University of Washington, Seattle, Washington
| | - Krystle Perez
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - T Michael O'Shea
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC
| | - Veeral N Tolia
- Pediatrix Medical Group, Dallas TX
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, FL
| | - Reese H Clark
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, FL
| | - Patrick J Heagerty
- Center for Biomedical Statistics, University of Washington, Seattle, Washington
| | - Sandra E Juul
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Kaashif A Ahmad
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, FL
- Pediatrix Medical Group of San Antonio, San Antonio, TX
- Department of Pediatrics, Baylor College of Medicine, San Antonio, TX
- Pediatrix and Obstetrix Specialists of Houston, Houston, TX
- Department of Clinical Sciences, University of Houston, Houston, TX
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Orton J, Doyle LW, Tripathi T, Boyd R, Anderson PJ, Spittle A. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database Syst Rev 2024; 2:CD005495. [PMID: 38348930 PMCID: PMC10862558 DOI: 10.1002/14651858.cd005495.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
BACKGROUND Infants born preterm are at increased risk of cognitive and motor impairments compared with infants born at term. Early developmental interventions for preterm infants are targeted at the infant or the parent-infant relationship, or both, and may focus on different aspects of early development. They aim to improve developmental outcomes for these infants, but the long-term benefits remain unclear. This is an update of a Cochrane review first published in 2007 and updated in 2012 and 2015. OBJECTIVES Primary objective To assess the effect of early developmental interventions compared with standard care in prevention of motor or cognitive impairment for preterm infants in infancy (zero to < three years), preschool age (three to < five years), and school age (five to < 18 years). Secondary objective To assess the effect of early developmental interventions compared with standard care on motor or cognitive impairment for subgroups of preterm infants, including groups based on gestational age, birthweight, brain injury, timing or focus of intervention and study quality. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and trial registries in July 2023. We cross-referenced relevant literature, including identified trials and existing review articles. SELECTION CRITERIA Studies included randomised, quasi-randomised controlled trials (RCTs) or cluster-randomised trials of early developmental intervention programmes that began within the first 12 months of life for infants born before 37 weeks' gestational age (GA). Interventions could commence as an inpatient but had to include a post discharge component for inclusion in this review. Outcome measures were not prespecified, other than that they had to assess cognitive outcomes, motor outcomes or both. The control groups in the studies could receive standard care that would normally be provided. DATA COLLECTION AND ANALYSIS Data were extracted from the included studies regarding study and participant characteristics, timing and focus of interventions and cognitive and motor outcomes. Meta-analysis using RevMan was carried out to determine the effects of early developmental interventions at each age range: infancy (zero to < three years), preschool age (three to < five years) and school age (five to < 18 years) on cognitive and motor outcomes. Subgroup analyses focused on GA, birthweight, brain injury, time of commencement of the intervention, focus of the intervention and study quality. We used standard methodological procedures expected by Cochrane to collect data and evaluate bias. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS Forty-four studies met the inclusion criteria (5051 randomly assigned participants). There were 19 new studies identified in this update (600 participants) and a further 17 studies awaiting outcomes. Three previously included studies had new data. There was variability in the focus and intensity of the interventions, participant characteristics, and length of follow-up. All included studies were either single or multicentre trials and the number of participants varied from fewer than 20 to up to 915 in one study. The trials included in this review were mainly undertaken in middle- or high-income countries. The majority of studies commenced in the hospital, with fewer commencing once the infant was home. The focus of the intervention programmes for new included studies was increasingly targeted at both the infant and the parent-infant relationship. The intensity and dosages of interventions varied between studies, which is important when considering the applicability of any programme in a clinical setting. Meta-analysis demonstrated that early developmental intervention may improve cognitive outcomes in infancy (developmental quotient (DQ): standardised mean difference (SMD) 0.27 standard deviations (SDs), 95% confidence interval (CI) 0.15 to 0.40; P < 0.001; 25 studies; 3132 participants, low-certainty evidence), and improves cognitive outcomes at preschool age (intelligence quotient (IQ); SMD 0.39 SD, 95% CI 0.29 to 0.50; P < 0.001; 9 studies; 1524 participants, high-certainty evidence). However, early developmental intervention may not improve cognitive outcomes at school age (IQ: SMD 0.16 SD, 95% CI -0.06 to 0.38; P = 0.15; 6 studies; 1453 participants, low-certainty evidence). Heterogeneity between studies for cognitive outcomes in infancy and preschool age was moderate and at school age was substantial. Regarding motor function, meta-analysis of 23 studies showed that early developmental interventions may improve motor outcomes in infancy (motor scale DQ: SMD 0.12 SD, 95% CI 0.04 to 0.19; P = 0.003; 23 studies; 2737 participants, low-certainty evidence). At preschool age, the intervention probably did not improve motor outcomes (motor scale: SMD 0.08 SD, 95% CI -0.16 to 0.32; P = 0.53; 3 studies; 264 participants, moderate-certainty evidence). The evidence at school age for both continuous (motor scale: SMD -0.06 SD, 95% CI -0.31 to 0.18; P = 0.61; three studies; 265 participants, low-certainty evidence) and dichotomous outcome measures (low score on Movement Assessment Battery for Children (ABC) : RR 1.04, 95% CI 0.82 to 1.32; P = 0.74; 3 studies; 413 participants, low-certainty evidence) suggests that intervention may not improve motor outcome. The main source of bias was performance bias, where there was a lack of blinding of participants and personnel, which was unavoidable in this type of intervention study. Other biases in some studies included attrition bias where the outcome data were incomplete, and inadequate allocation concealment or selection bias. The GRADE assessment identified a lower certainty of evidence in the cognitive and motor outcomes at school age. Cognitive outcomes at preschool age demonstrated a high certainty due to more consistency and a larger treatment effect. AUTHORS' CONCLUSIONS Early developmental intervention programmes for preterm infants probably improve cognitive and motor outcomes during infancy (low-certainty evidence) while, at preschool age, intervention is shown to improve cognitive outcomes (high-certainty evidence). Considerable heterogeneity exists between studies due to variations in aspects of the intervention programmes, the population and outcome measures utilised. Further research is needed to determine which types of early developmental interventions are most effective in improving cognitive and motor outcomes, and in particular to discern whether there is a longer-term benefit from these programmes.
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Affiliation(s)
- Jane Orton
- Royal Women's Hospital, Parkville, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Tanya Tripathi
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Roslyn Boyd
- The University of Queensland, Brisbane, Australia
| | - Peter J Anderson
- Department of Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Alicia Spittle
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
- Murdoch Childrens Research Institute and the University of Melbourne, Parkville, Australia
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Mahabee-Gittens EM, Harun N, Glover M, Folger AT, Parikh NA. Prenatal tobacco smoke exposure and risk for cognitive delays in infants born very premature. Sci Rep 2024; 14:1397. [PMID: 38228701 PMCID: PMC10791619 DOI: 10.1038/s41598-024-51263-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024] Open
Abstract
Prenatal tobacco smoke exposure (TSE) and prematurity are independent risk factors for abnormal neurodevelopment. The objectives were to compare differences in Bayley-III cognitive, language, and motor scores at 2 years corrected age (CA) in 395 infants born very preterm (≤ 32 weeks gestation) with and without prenatal TSE. We performed multivariable linear regression analyses to examine associations between prenatal TSE and neurodevelopmental outcomes and a mediation analysis to estimate direct effects of prenatal TSE on outcomes and indirect effects through preterm birth. In total, 50 (12.6%) infants had prenatal TSE. Infants with prenatal TSE had lower mean [95% CI] Cognitive score (82.8 [78.6, 87.1]) vs. nonexposed infants (91.7 [90.1, 93.4]). In children with and without prenatal TSE, there were significant differences in mean [95% CI] Language scores (81.7 [76.0, 87.4] vs. 92.4 [90.2, 94.6], respectively) and mean [95% CI] Motor scores (86.5 [82.2, 90.7] vs. 93.4 [91.8, 95.0], respectively); scores remained significant after controlling for confounders. Preterm birth indirectly mediated 9.0% of the total effect of prenatal TSE on Cognitive score (P = NS). However, 91% of the remaining total effect was significant and attributable to TSE's direct harmful effects on cognitive development (β = - 5.17 [95% CI - 9.97, - 0.38]). The significant association is largely due to TSE's direct effect on cognitive development and not primarily due to TSE's indirect effect on preterm birth.
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Affiliation(s)
- E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
| | - Nusrat Harun
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Meredith Glover
- Neurodevelopmental Disorders Prevention Center, The Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Alonzo T Folger
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Nehal A Parikh
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Neurodevelopmental Disorders Prevention Center, The Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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Gilchrist CP, Kelly CE, Cumberland A, Dhollander T, Treyvaud K, Lee K, Cheong JLY, Doyle LW, Inder TE, Thompson DK, Tolcos M, Anderson PJ. Fiber-Specific Measures of White Matter Microstructure and Macrostructure Are Associated With Internalizing and Externalizing Symptoms in Children Born Very Preterm and Full-term. Biol Psychiatry 2023; 93:575-585. [PMID: 36481064 DOI: 10.1016/j.biopsych.2022.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/06/2022] [Accepted: 09/10/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Tensor-based investigations suggest that delayed or disrupted white matter development may relate to adverse behavioral outcomes in individuals born very preterm (VP); however, metrics derived from such models lack specificity. Here, we applied a fixel-based analysis framework to examine white matter microstructural and macrostructural correlates of concurrent internalizing and externalizing problems in VP and full-term (FT) children at 7 and 13 years. METHODS Diffusion imaging data were collected in a longitudinal cohort of VP and FT individuals (130 VP and 29 FT at 7 years, 125 VP and 44 FT at 13 years). Fixel-based measures of fiber density, fiber-bundle cross-section, and fiber density and cross-section were extracted from 21 white matter tracts previously implicated in psychopathology. Internalizing and externalizing symptoms were assessed using the Strengths and Difficulties Questionnaire parent report at 7 and 13 years. RESULTS At age 7 years, widespread reductions in fiber-bundle cross-section and fiber density and cross-section and tract-specific reductions in fiber density were related to more internalizing and externalizing symptoms irrespective of birth group. At age 13 years, fixel-based measures were not related to internalizing symptoms, while tract-specific reductions in fiber density, fiber-bundle cross-section, and fiber density and cross-section measures were related to more externalizing symptoms in the FT group only. CONCLUSIONS Age-specific neurobiological markers of internalizing and externalizing problems identified in this study extend previous tensor-based findings to inform pathophysiological models of behavior problems and provide the foundation for investigations into novel preventative and therapeutic interventions to mitigate risk in VP and other high-risk infant populations.
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Affiliation(s)
- Courtney P Gilchrist
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
| | - Claire E Kelly
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Melbourne, Victoria, Australia
| | - Angela Cumberland
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Thijs Dhollander
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Karli Treyvaud
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Psychology and Counselling, La Trobe University, Melbourne, Victoria, Australia; Newborn Research, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Katherine Lee
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Newborn Research, Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Newborn Research, Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Terrie E Inder
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Deanne K Thompson
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Mary Tolcos
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Melbourne, Victoria, Australia.
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Abstract
OBJECTIVES Children born very preterm (VP) are susceptible to a range of cognitive impairments, yet the effects of VP birth on long-term, episodic, and prospective memory remains unclear. This study examined episodic and prospective memory functioning in children born VP compared with their term-born counterparts at 13 years. METHOD VP (n = 81: born <30 weeks' gestation) and term (n = 26) groups were aged between 12 and 14 years. Children completed: (i) standardized verbal and visuospatial episodic memory tests; and (ii) an experimental time- and event-based prospective memory test that included short-term (within assessment session) and long-term (up to 1-week post-session) tasks. Parents completed a questionnaire assessing memory functions in everyday life. RESULTS The VP group performed worse on all measures of verbal and visuospatial episodic memory than the term group. While there were no group differences in event-based or long-term prospective memory, the VP group performed worse on time-based and short-term prospective memory tasks than term-born counterparts. Parents of children born VP reported more everyday memory difficulties than parents of children born at term, with parent-ratings indicating significantly elevated rates of everyday memory challenges in children born VP. CONCLUSIONS Children born VP warrant long-term surveillance, as challenges associated with VP birth include memory difficulties at 13 years. This study highlights the need for greater research and clinical attention into childhood functional memory outcomes.
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9
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Brown RN, Pascoe L, Treyvaud K, McMahon G, Nguyen TNN, Ellis R, Stedall P, Haebich K, Collins SE, Cheong J, Doyle LW, Thompson DK, Burnett A, Anderson PJ. Early parenting behaviour is associated with complex attention outcomes in middle to late childhood in children born very preterm. Child Neuropsychol 2023; 29:165-182. [PMID: 35549808 DOI: 10.1080/09297049.2022.2075334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Attention deficits are common in children born very preterm (VP), especially for children with higher social risk. The aim of this study was to examine the association between parenting behavior and attention in children born VP, and whether this association is influenced by familial social risk. Two hundred and twenty-four children born <30 weeks' gestation and/or with a birth weight <1250 g were recruited at birth. At 2 years, social risk was calculated and parenting behaviors were observed during a parent-child interaction task, with children's attention skills assessed at 7 and 13 years using standardized assessments. Higher levels of sensitive parenting at 2 years were positively associated with divided attention at age 7 years, and higher levels of intrusive parenting were negatively associated with divided attention at 13 years. Children born VP with higher social risk were more positively influenced by sensitive parenting behavior for sustained attention at 7 years, selective attention at 13 years, and divided attention at 7 and 13 years than children born VP with lower social risk. Additionally, children born VP with higher social risk were more negatively influenced by intrusive parenting for sustained attention outcomes at 7 years than those with lower social risk. In summary, the evidence for a contribution of early parenting to attention outcomes in children born VP was stronger for more complex attention (divided attention) compared with basic attention domains. Our findings also suggest that early parenting behavior has a particular influence on children born VP from socially disadvantaged environments for attention outcomes.
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Affiliation(s)
- Rebecca N Brown
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Leona Pascoe
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Karli Treyvaud
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Psychology and Counselling, La Trobe University, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Victoria, Australia
| | - Grace McMahon
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Thi-Nhu-Ngoc Nguyen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Rachel Ellis
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Paulina Stedall
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Kristina Haebich
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia
| | - Simonne E Collins
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Jeanie Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Alice Burnett
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
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10
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Barra L, Coo S. Preterm‐born children's development: A bioecological perspective. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lisseth Barra
- School of Psycholy Universidad del Desarrollo Santiago Chile
- Deparment of Physical Therapy, Faculty of Medicine University of Chile Santiago Chile
| | - Soledad Coo
- School of Psycholy Universidad del Desarrollo Santiago Chile
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11
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Akgül Gündoğdu N, Temel Mert Z, Gündüz ES. Not being able to hug our baby before the cables: Early experiences of parents with premature babies. Nurs Forum 2022; 57:1193-1203. [PMID: 36308316 DOI: 10.1111/nuf.12822] [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: 02/23/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The nursing care provided after the intensive care period and discharge can contribute to the optimal growth and development of the baby while protecting the mental health of the parents. OBJECTIVE The aim of this study is to examine in detail the experiences of parents with premature babies about having a premature baby and their experiences with the hospitalization process of their babies in the neonatal intensive care unit (NICU). DESIGN The methodological approach was informed by Van Manen's hermeneutic phenomenological methodology. The sample consisted of 15 parents who had a preterm baby in the NICU of a state hospital in Turkey. RESULTS The data obtained from this study were categorized under four themes: having a preterm baby, perception of intensive care, feelings toward nurses, emotions about discharge and home care. CONCLUSIONS Health professionals should know what the parents' perception of being a parent and having a premature baby is.
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Affiliation(s)
- Nurcan Akgül Gündoğdu
- Department of Public Health Nursing, Faculty of Health Science, Bandirma Onyedi Eylul University, Bandirma, Balıkesir, Turkey
| | - Zeynep Temel Mert
- Department of Child Health and Disease Nursing, School of Suşehri Health, University of Sivas Cumhuriyet, Sivas, Turkey
| | - Emine Selda Gündüz
- Department of Medical Services and Techniques, Vocational School of Health Services, First and Emergency Aid Programme, Akdeniz University, Antalya, Turkey
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12
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Ni ZH, Ding S, Wu JH, Wang F. Family caregivers' experiences of caring for neonates undergoing enterostomy in China: A qualitative study. Nurs Open 2022; 10:817-827. [PMID: 36040011 PMCID: PMC9834189 DOI: 10.1002/nop2.1350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/07/2022] [Accepted: 08/22/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To describe the nursing experiences and care needs of family caregivers caring for neonates with enterostomies in China. DESIGN A qualitative study. METHODS We conducted semi-structured interviews with family caregivers who care for neonates undergoing enterostomy. Family caregivers were selected using a purposive sampling method from three children's hospitals until no new data were generated (N = 26). Data analysis applied the thematic analysis method. The caregivers' experiences were described using qualitative content analysis. RESULTS The experience of family caregivers was described as growing in adaptation, where five main themes emerged: (1) complex emotional responses; (2) uncertainty about everything; (3) lack of confidence, anxiety and helplessness; (4) eagerness for professional support; (5) active adaptation, gain-harvest and gain-growth. These findings increased understanding and added knowledge on this topic that is rarely studied in China. Healthcare authorities and professionals should recognize and understand the lives and situations of family caregivers (whose neonates undergo enterostomy) to better identify their difficulties and needs.
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Affiliation(s)
- Zhi Hong Ni
- Children's Hospital of Soochow UniversitySuzhouChina
| | - Sheng Ding
- Children's Hospital of Soochow UniversitySuzhouChina
| | - Jin Hua Wu
- Children's Hospital of Soochow UniversitySuzhouChina
| | - Fang Wang
- Children's Hospital of Soochow UniversitySuzhouChina
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13
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Stedall PM, Spencer-Smith MM, Mainzer RM, Treyvaud K, Burnett AC, Doyle LW, Spittle AJ, Anderson PJ. Thirteen-Year Outcomes of a Randomized Clinical Trial of Early Preventive Care for Very Preterm Infants and Their Parents. J Pediatr 2022; 246:80-88.e4. [PMID: 35304169 DOI: 10.1016/j.jpeds.2022.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/22/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate 13-year outcomes of a randomized controlled trial of preventive care (VIBeS Plus) for infants born very preterm and their parents and examine whether possible effects of intervention varied by family social risk. STUDY DESIGN Families were randomized to an intervention arm (n = 61) or a standard care arm (n = 59). The intervention was delivered at home by psychologists and physiotherapists over the infants' first year, focusing on infant development and parental mental health. At 13 years corrected age, cognitive, motor, and behavioral outcomes, and parental mental health were assessed. Primary estimands were between-group mean differences, estimated using multiple imputed regression models. RESULTS Follow-up included 81 surviving children (69%). There was little evidence of benefits of the intervention for IQ, attention, executive functioning, working memory, and academic skills regardless of level of social risk. Specifically, mean differences in adolescent cognitive outcomes ranged from -2.0 units (95% CI, -9.9 to 5.9) in favor of standard treatment to 5.1 units (95% CI, -2.3 to 12.5) favoring the intervention. A group-by-social risk interaction was observed only for adolescent motor outcomes, with mean differences favoring the intervention for those at higher social risk (balance, 4.9; 95% CI, 1.3-8.5; total motor, 3.2; 95% CI, 0.3-6.2), but not those at lower social risk (balance, -0.3; 95% CI, -2.4 to 1.9; total motor, 0.03; 95% CI, -1.9 to 2.0). Mean differences in adolescent behavior and parental mental health ranged from -6.6 (95% CI -13.8, 0.5) to -0.2 (95% CI, -1.9 to 1.4) and -1.8 (95% CI, -4.1 to 0.6) to -1.7 (95% CI, -4.3 to 1.0), respectively, indicating a pattern of fewer symptoms in the intervention group. CONCLUSIONS Benefits of the intervention persisted for adolescent behavior, with better motor outcomes observed in those from socially disadvantaged families. Replication with larger samples, multiple informant reports, and assessment of quality of life-related outcomes is warranted. TRIAL REGISTRATION http://www.anzctr.org.au/: ACTRN12605000492651.
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Affiliation(s)
- Paulina M Stedall
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Megan M Spencer-Smith
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Rheanna M Mainzer
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Karli Treyvaud
- Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Psychology and Counselling, La Trobe University, Melbourne, Australia
| | - Alice C Burnett
- Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Premature Infant Follow-up Program, Royal Women's Hospital, Parkville, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Neonatal Medicine, Royal Children's Hospital, Parkville, Australia
| | - Lex W Doyle
- Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Premature Infant Follow-up Program, Royal Women's Hospital, Parkville, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Australia
| | - Alicia J Spittle
- Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Newborn Research, Royal Women's Hospital, Parkville, Australia; Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; Department of Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
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14
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Ochandorena-Acha M, Terradas-Monllor M, López Sala L, Cazorla Sánchez ME, Fornaguera Marti M, Muñoz Pérez I, Agut-Quijano T, Iriondo M, Casas-Baroy JC. Early Physiotherapy Intervention Program for Preterm Infants and Parents: A Randomized, Single-Blind Clinical Trial. CHILDREN 2022; 9:children9060895. [PMID: 35740832 PMCID: PMC9222162 DOI: 10.3390/children9060895] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/20/2022]
Abstract
Background: The early developmental interventions might be designed with a preventative approach to improving the development of at-risk preterm infants. The present study aimed to evaluate the effectiveness of an early physiotherapy intervention on preterm infants’ motor and global development, and on parents’ stress index. Methods: 48 infants were enrolled and randomized into two groups. Infants allocated to the intervention group received an early physiotherapy intervention, based on parental education sessions and tactile and kinesthetic stimulation during the NICU period, as well as a home-based activity program. The intervention commenced after 32 weeks post-menstrual age and ended at 2 months corrected age. Infants allocated to the control group received the usual care based on the NIDCAP-care. Results: No differences were found between groups on the Alberta Infant Motor Scale at 2- or 8-months corrected age. Infants in the intervention group showed more optimal fine motor, problem-solving, personal-social, and communication development at 1 month corrected age. Conclusions: The results showed no effect on the early physiotherapy intervention. Results might be related to the dose or intensity of the intervention, but also to the poor parental compliance. ClinicalTrials.gov NCT03313427.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Marc Terradas-Monllor
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
- Pain Medicine Section, Anaesthesiology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Catalonia, Spain
- Correspondence:
| | - Laura López Sala
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Maria Engracia Cazorla Sánchez
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Montserrat Fornaguera Marti
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Isabel Muñoz Pérez
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Thais Agut-Quijano
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Martín Iriondo
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Joan Carles Casas-Baroy
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
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15
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McKenzie K, Lynch E, Msall ME. Scaffolding Parenting and Health Development for Preterm Flourishing Across the Life Course. Pediatrics 2022; 149:186921. [PMID: 35503323 PMCID: PMC9847416 DOI: 10.1542/peds.2021-053509k] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 01/21/2023] Open
Abstract
Advances in obstetrics and neonatal medicine have resulted in improved survival rates for preterm infants. Remarkably, >75% extremely (<28 weeks) preterm infants who leave the NICU do not experience major neurodevelopmental disabilities, although >50% experience more minor challenges in communication, perception, cognition, attention, regulatory, and executive function that can adversely impact educational and social function resulting in physical, behavioral, and social health issues in adulthood. Even late premature (32-36 weeks) infants have more neurodevelopmental challenges than term infants. Although early intervention and educational programs can mitigate risks of prematurity for children's developmental trajectories, restrictive eligibility requirement and limitations on frequency and intensity mean that many premature infants must "fail first" to trigger services. Social challenges, including lack of family resources, unsafe neighborhoods, structural racism, and parental substance use, may compound biological vulnerabilities, yet existing services are ill-equipped to respond. An intervention system for premature infants designed according to Life Course Health Development principles would instead focus on health optimization from the start; support emerging developmental capabilities such as self-regulation and formation of reciprocal secure early relationships; be tailored to each child's unique neurodevelopmental profile and social circumstances; and be vertically, horizontally, and longitudinally integrated across levels (individual, family, community), domains (health, education), and time. Recognizing the increased demands placed on parents, it would include parental mental health supports and provision of trauma-informed care. This developmental scaffolding would incorporate parenting, health, and developmental interventions, with the aim of improved health trajectories across the whole of the life course.
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Affiliation(s)
- Kamryn McKenzie
- University of Chicago Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, Illinois
| | - Emma Lynch
- University of Chicago Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, Illinois
| | - Michael E. Msall
- Address correspondence to Address correspondence to: Michael E. Msall, MD, Section of Developmental and Behavioral Pediatrics, University of Chicago Kennedy Research Center and Comer Children's Hospital, 936 East 61 St Street, Room 207, Chicago, IL 60637. E-mail:
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16
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Harniess PA, Gibbs D, Bezemer J, Purna Basu A. Parental engagement in early intervention for infants with cerebral palsy-A realist synthesis. Child Care Health Dev 2022; 48:359-377. [PMID: 34622968 PMCID: PMC9298289 DOI: 10.1111/cch.12916] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 09/15/2021] [Accepted: 10/04/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Emphasis on parental engagement strategies within occupational therapy and physiotherapy early intervention (EI) programmes for infants at high risk of cerebral palsy (CP) has increased. This reflects consensus that increasing parent participation enhances treatment efficacy, potentially improving infant and parent outcomes. However, evaluation of parental engagement in EI is complex. Despite the growing application of parental engagement strategies, aligned with family-centred care practice, theoretical evaluation is currently lacking within the literature. This realist synthesis aimed to identify component theories underlying EI strategies to support parental engagement and to use empirical findings to evaluate how these work in practice. METHODS Realist synthesis: Databases Medline, Embase, Amed, CINAHL and PsychInfo were searched (from February 1985 - February 2020); further articles were sourced from reference lists. A data extraction form was used, and a Critical Appraisal Skills Programme tool was used to assess study rigour. RESULTS Twenty-six articles were included. Quality of relationships, parent education and intervention co-design were the key themes related to parental engagement strategies. Findings indicate that constructive parent reasoning mechanisms of trust, belief, sense of control, perceived feasibility of home programme delivery and ultimately motivation are linked to the underlying intervention resources afforded by specific strategies (e.g., coaching pedagogy). These responses are precursors to engagement outcomes that include increased parental self-efficacy and adherence. Importantly, parental self-efficacy can initiate a process of change leading to improved parental confidence and anxiety. CONCLUSIONS Sensitively designed programme strategies, centred on relational quality between parent, infant and therapist, are fundamental for effective parent connection, involvement and investment within EI for infants with CP.
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Affiliation(s)
- Phillip Antony Harniess
- Physiotherapy DepartmentGreat Ormond Street HospitalLondonUK,Institute of EducationUniversity College LondonLondonUK
| | - Deanna Gibbs
- Children's ResearchBarts Health NHS TrustLondonUK
| | - Jeff Bezemer
- Institute of EducationUniversity College LondonLondonUK
| | - Anna Purna Basu
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK,Department of Paediatric NeurologyNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
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17
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Neel ML, de Silva A, Taylor HG, Benninger K, Busch T, Hone E, Moore-Clingenpeel M, Pietruszewski L, Maitre NL. Exceeding expectations after perinatal risks for poor development: associations in term- and preterm-born preschoolers. J Perinatol 2022; 42:491-498. [PMID: 34711935 DOI: 10.1038/s41372-021-01254-9] [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] [Received: 02/26/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To define parenting/social characteristics associated with better-than-expected cognitive and motor outcomes in preschoolers at similar perinatal biological risk-level including various gestational ages at birth (GA) and perinatal complications. STUDY DESIGN Prospective cohort study (n = 87) of children at four years, median GA 29 weeks (IQR 26, 38). Assessments included Differential Ability Scales, Movement Assessment Battery, parenting styles, and social risk scores. Perinatal risk factors were weighted based on regression models for each outcome; individual calculated risk scores became predictors to extract standardized residuals from the mean (>1 SD above mean = better-than-expected). Mixed-effect regressions examined associations between positive adaptation and parenting/social factors. RESULT Perinatal risk scores explained 21-53% outcome variability. Children across all GA displayed positive adaptation. Children of parents with higher authoritarian scores had higher odds of better-than-expected outcomes (OR 1.17, p = 0.0002). CONCLUSION Parental structure may promote positive adaptation at preschool age in children with perinatal risk factors for poor development, including extreme prematurity.
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Affiliation(s)
- Mary Lauren Neel
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA. .,Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Aryanne de Silva
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - H Gerry Taylor
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.,Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kristen Benninger
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Tyler Busch
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Emily Hone
- Biostatistics Core, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Melissa Moore-Clingenpeel
- Biostatistics Core, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Lindsay Pietruszewski
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Nathalie L Maitre
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
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18
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Seppänen AV, Draper ES, Petrou S, Barros H, Aubert AM, Andronis L, Kim SW, Maier RF, Pedersen P, Gadzinowski J, Lebeer J, Ådén U, Toome L, van Heijst A, Cuttini M, Zeitlin J. High Healthcare Use at Age 5 Years in a European Cohort of Children Born Very Preterm. J Pediatr 2022; 243:69-77.e9. [PMID: 34921871 DOI: 10.1016/j.jpeds.2021.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/21/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To describe parent-reported healthcare service use at age 5 years in children born very preterm and investigate whether perinatal and social factors and the use of very preterm follow-up services are associated with high service use. STUDY DESIGN We used data from an area-based cohort of births at <32 weeks of gestation from 11 European countries, collected from birth records and parental questionnaires at 5 years of age. Using the published literature, we defined high use of outpatient/inpatient care (≥4 sick visits to general practitioners, pediatricians, or nurses, ≥3 emergency room visits, or ≥1 overnight hospitalization) and specialist care (≥2 different specialists or ≥3 visits). We also categorized countries as having either a high or a low rate of children using very preterm follow-up services at age 5 years. RESULTS Overall, 43% of children had high outpatient/inpatient care use and 48% had high specialist care use during the previous year. Perinatal factors were associated with high outpatient/inpatient and specialist care use, with a more significant association with specialist services. Associations with intermediate parental educational level and unemployment were stronger for outpatient/inpatient services. Living in a country with higher rates of very preterm follow-up service use was associated with lower use of outpatient/inpatient services. CONCLUSIONS Children born very preterm had high healthcare service use at age 5 years, with different patterns for outpatient/inpatient and specialist care by perinatal and social factors. Longer follow-up of children born very preterm may improve care coordination and help avoid undesirable health service use.
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Affiliation(s)
- Anna-Veera Seppänen
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, Center of Research in Epidemiology and Statistics, Université de Paris, INSERM, INRAE, Paris, France.
| | - Elizabeth S Draper
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Henrique Barros
- Epidemiology Research Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Adrien M Aubert
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, Center of Research in Epidemiology and Statistics, Université de Paris, INSERM, INRAE, Paris, France
| | - Lazaros Andronis
- Division of Clinical Trials, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Sung Wook Kim
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Rolf F Maier
- Department of Neonatology, Children's Hospital, University Hospital, Philipps University Marburg, Marburg, Germany
| | | | - Janusz Gadzinowski
- Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jo Lebeer
- Department of Family Medicine & Population Health, Disability Studies, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ulrika Ådén
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Liis Toome
- Department of Neonatal and Infant Medicine, Tallinn Children's Hospital, Tallinn, Estonia; Department of Pediatrics, University of Tartu, Tartu, Estonia
| | - Arno van Heijst
- Department of Neonatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Jennifer Zeitlin
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, Center of Research in Epidemiology and Statistics, Université de Paris, INSERM, INRAE, Paris, France
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19
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Taylor HG, Vrantsidis DM, Neel ML, Benkart R, Busch TA, de Silva A, Udaipuria S, Maitre NL. School Readiness in 4-Year-Old Very Preterm Children. CHILDREN 2022; 9:children9030323. [PMID: 35327695 PMCID: PMC8947581 DOI: 10.3390/children9030323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 11/22/2022]
Abstract
The aims of this study were to identify the aspects of school readiness that best distinguish very preterm (VPT) preschoolers from full-term (FT) controls, determine the extent to which readiness problems in the VPT group reflected global cognitive weaknesses or more specific deficits, and identify distinct profiles of readiness problems. Fifty-three VPT (gestational age ≤ 30 weeks) 4-year-olds were compared to 38 FT (gestational age ≥ 37 weeks) controls on measures of global cognitive ability, executive function, motor skills, early literacy and numeracy, and psychosocial functioning. Latent class analysis (LCA) was also conducted to identify individual readiness profiles. The VPT group had the most pronounced difficulties on tests of spatial and nonverbal cognitive abilities, executive function, motor skills, phonological processing, and numeracy. The VPT group also had sex-related difficulties in processing speed, social functioning, and emotion regulation. These differences were evident in analyses of both continuous scores and rates of deficits. The VPT group’s difficulties in motor skills, and VPT females’ difficulties in social functioning and emotion regulation, were evident even when controlling for global cognitive ability. LCA suggested four profiles of readiness, with the majority of the VPT group assigned to profiles characterized by relative weaknesses in either cognitive abilities or psychosocial functioning or by more global readiness problems. The findings support the need to evaluate multiple aspects of school readiness in VPT preschoolers and inform efforts to design more targeted early educational interventions.
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Affiliation(s)
- H. Gerry Taylor
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
- Correspondence: ; Tel.: +1-614-722-3184
| | - Daphne M. Vrantsidis
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Mary Lauren Neel
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
| | - Rebekah Benkart
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Tyler A. Busch
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
| | - Aryanne de Silva
- Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA; (D.M.V.); (M.L.N.); (R.B.); (T.A.B.); (A.d.S.)
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
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PreEMPT (Preterm infant Early intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial. Early Hum Dev 2022; 166:105551. [PMID: 35152175 DOI: 10.1016/j.earlhumdev.2022.105551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/06/2022] [Accepted: 01/31/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE Investigate feasibility of PreEMPT: a novel participation-focused, early physiotherapy intervention for preterm infants in regional Australia. MATERIALS AND METHODS Participants were infants born <35 weeks, residing in regional Australia. Sixteen infants were recruited then randomised to usual physiotherapy care (UPC: n = 8) or PreEMPT (n = 8). PreEMPT involved 14-weeks of alternating clinic- or telehealth-based, participation-focused intervention. Feasibility was evaluated by: demand, practicality, acceptability, implementation and limited efficacy testing for infants (motor, participation) and parents (mental well-being, self-efficacy). RESULTS Demand was lower than expected (45% recruitment rate). For practicality, attrition was high in the PreEMPT group (mean assessment attendance 3.8/5 sessions, range 2-5) compared to UPC (4.8/5 sessions, range 4-5). In addition, mean PreEMPT treatment dose received was approximately half intended (overall: 7.3/14 sessions, range 0-12; equivalent for face-to-face: 3.9/7, range 0-6, versus telehealth 3.4/7, range 0-6). The most common reason cited for treatment non-attendance was maternal mental health (22 sessions). Treatment acceptability for parents was high, with PreEMPT parents reporting they were offered choices in sessions (p = .02), and increased their knowledge (p = .01) and confidence (p = .009). There was a large effect size in favour of PreEMPT for increased parental self-efficacy (p = .021, ES = 1.34). CONCLUSION Early post-discharge physiotherapy for preterm infants in regional Australia is beneficial according to families but logistically challenging.
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21
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Sentenac M, Benhammou V, Aden U, Ancel PY, Bakker LA, Bakoy H, Barros H, Baumann N, Bilsteen JF, Boerch K, Croci I, Cuttini M, Draper E, Halvorsen T, Johnson S, Källén K, Land T, Lebeer J, Lehtonen L, Maier RF, Marlow N, Morgan A, Ni Y, Raikkonen K, Rtimi A, Sarrechia I, Varendi H, Vollsaeter M, Wolke D, Ylijoki M, Zeitlin J. Maternal education and cognitive development in 15 European very-preterm birth cohorts from the RECAP Preterm platform. Int J Epidemiol 2022; 50:1824-1839. [PMID: 34999864 DOI: 10.1093/ije/dyab170] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies are sparse and inconclusive about the association between maternal education and cognitive development among children born very preterm (VPT). Although this association is well established in the general population, questions remain about its magnitude among children born VPT whose risks of medical and developmental complications are high. We investigated the association of maternal education with cognitive outcomes in European VPT birth cohorts. METHODS We used harmonized aggregated data from 15 population-based cohorts of children born at <32 weeks of gestational age (GA) or <1500 g from 1985 to 2013 in 13 countries with information on maternal education and assessments of general development at 2-3 years and/or intelligence quotients between 4 and 15 years. Term-born controls (≥37 weeks of GA) were available in eight cohorts. Maternal education was classified as: low (primary/lower secondary); medium (upper secondary/short tertiary); high (bachelor's/higher). Pooled standardized mean differences (SMDs) in cognitive scores were estimated (reference: high educational level) for children assessed at ages 2-3, 4-7 and 8-15 years. RESULTS The study included 10 145 VPT children from 12 cohorts at 2-3 years, 8829 from 12 cohorts at 4-7 years and 1865 children from 6 cohorts at 8-15 years. Children whose mothers had low, compared with high, educational attainment scored lower on cognitive measures [pooled unadjusted SMDs: 2-3 years = -0.32 (95% confidence intervals: -0.43 to -0.21); 4-7 years = -0.57 (-0.67; -0.47); 8-15 years = -0.54 (-0.72; -0.37)]. Analyses by GA subgroups (<27 vs ≥27 weeks) in children without severe neonatal morbidity and term controls yielded similar results. CONCLUSIONS Across diverse settings and regardless of the degree of prematurity, low maternal education was associated with lower cognition.
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Affiliation(s)
- Mariane Sentenac
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
| | - Valérie Benhammou
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
| | - Ulrika Aden
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Pierre-Yves Ancel
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
| | - Leonhard A Bakker
- Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Hannah Bakoy
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - Josephine Funck Bilsteen
- Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Boerch
- Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Denmark
| | - Ileana Croci
- Clinical Care and Management Innovation Research Area, Bambino Gesù Pediatric Hospital, Roma, Lazio, Italy
| | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Pediatric Hospital, Roma, Lazio, Italy
| | - Elizabeth Draper
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Thomas Halvorsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Karin Källén
- Department of Obstetrics and Gynecology, Unit of Reproduction Epidemiology, Institution of Clinical Sciences, University of Lund, Lund, Sweden
| | - Tuuli Land
- Department of Pediatrics, University of Tartu, Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - Jo Lebeer
- Department of Family Medicine & Population Health, Disability Studies, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Liisa Lehtonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital Turku, Turku, Finland
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Rolf F Maier
- Children's Hospital, University Hospital, Philipps University Marburg, Marburg, Germany
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Andrei Morgan
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Yanyan Ni
- Department of Psychology, University of Warwick, Coventry, UK
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Katri Raikkonen
- Department of Psychology and Logopedics, University Of Helsinki, Helsinki, Finland
| | - Anass Rtimi
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
| | - Iemke Sarrechia
- Department of Family Medicine & Population Health, Disability Studies, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Heili Varendi
- Department of Pediatrics, University of Tartu, Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - Maria Vollsaeter
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - Milla Ylijoki
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital Turku, Turku, Finland
- Department of Paediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
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22
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Carmo ALSD, Fredo FW, Bruck I, Lima JDRMD, Janke RNRGH, Fogaça TDGM, Glaser JA, Riechi TIJDS, Antoniuk SA. Neurological, cognitive and learning evaluation of students who were born preterm. REVISTA PAULISTA DE PEDIATRIA 2021; 40:e2020252. [PMID: 34346991 PMCID: PMC8331067 DOI: 10.1590/1984-0462/2022/40/2020252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 11/22/2020] [Indexed: 11/21/2022]
Abstract
Objective: To evaluate the cognitive and academic profile of preterm newborns at school age and to determine the factors related to prematurity and sociodemographic profile that influence these results. Methods: Patients aged 6-14 years old that were assisted in the preterm follow-up clinic were recruited. The cognitive, academic, and neurological capacities were accessed through a detailed evaluation with a child neurologist, a neuropsychologist and a psychopedagogue. Neonatal data were collected from patient records. Results: 97 children were included and 14 were excluded from the study, resulting in 83 children. Gestational age (GA) was 30±3 weeks and weight at birth was 1138g (605 to 4185g). Poor performance was shown in 38.4% for writing, 57.5% for reading and 42.5% for mathematics. The mean total intelligence quotient (IQ) was 96±14.9 points, and 10.9% were considered altered. Children with unstructured families presented 78.3% of failure in reading tests (p=0.029). The multivariate analysis showed association between GA at birth and classic mini-mental score (p=0.043), total IQ (p=0.047), perceptual organization IQ (p=0.035), and processing speed IQ (p=0.036). There was also association between weight at birth and the classic (p=0.004) and adapted (p=0.007) mini-mental scores; invasive mechanic ventilation duration and classic mini-mental (p=0.049); and lower maternal age and processing speed IQ (p=0.033). Conclusions: Preterm infants at school age had high frequency of failure in cognitive and academic evaluation tests. Learning difficulties are high among them. Multiple neonatal variables are related with altered cognitive and students development.
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Affiliation(s)
| | | | - Isac Bruck
- Universidade Federal do Paraná. Curitiba, PR, Brasil
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23
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Pavlek LR, Rivera BK, Smith CV, Randle J, Hanlon C, Small K, Bell EF, Rysavy MA, Conroy S, Backes CH. Eligibility Criteria and Representativeness of Randomized Clinical Trials That Include Infants Born Extremely Premature: A Systematic Review. J Pediatr 2021; 235:63-74.e12. [PMID: 33894262 PMCID: PMC9348995 DOI: 10.1016/j.jpeds.2021.04.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/23/2021] [Accepted: 04/15/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess the eligibility criteria and trial characteristics among contemporary (2010-2019) randomized clinical trials (RCTs) that included infants born extremely preterm (<28 weeks of gestation) and to evaluate whether eligibility criteria result in underrepresentation of high-risk subgroups (eg, infants born at <24 weeks of gestation). STUDY DESIGN PubMed and Scopus were searched January 1, 2010, to December 31, 2019, with no language restrictions. RCTs with mean or median gestational ages at birth of <28 weeks of gestation were included. The study followed the PRISMA guidelines; outcomes were registered prospectively. Data extraction was performed independently by multiple observers. Study quality was evaluated using a modified Jadad scale. RESULTS Among RCTs (n = 201), 32 552 infants were included. Study participant characteristics, interventions, and outcomes were highly variable. A total of 1603 eligibility criteria were identified; rationales were provided for 18.8% (n = 301) of criteria. Fifty-five RCTs (27.4%) included infants <24 weeks of gestation; 454 (1.4%) infants were identified as <24 weeks of gestation. CONCLUSIONS The present study identifies sources of variability across RCTs that included infants born extremely preterm and reinforces the critical need for consistent and transparent policies governing eligibility criteria.
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Affiliation(s)
- Leeann R. Pavlek
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital,Department of Pediatrics and The Ohio State University Wexner Medical Center, Columbus, OH
| | - Brian K. Rivera
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital
| | - Charles V. Smith
- Center for Integrated Brain Research, Seattle Children’s Research Institute, Seattle, WA
| | - Joanie Randle
- Ohio Perinatal Research Network at Nationwide Children’s Hospital, Columbus, OH
| | - Cory Hanlon
- Ohio Perinatal Research Network at Nationwide Children’s Hospital, Columbus, OH
| | - Kristi Small
- Ohio Perinatal Research Network at Nationwide Children’s Hospital, Columbus, OH
| | - Edward F. Bell
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA
| | - Matthew A. Rysavy
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA
| | - Sara Conroy
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University,Biostatistics Resource at Nationwide Children’s Hospital
| | - Carl H. Backes
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital,Department of Pediatrics and The Ohio State University Wexner Medical Center, Columbus, OH,Ohio Perinatal Research Network at Nationwide Children’s Hospital, Columbus, OH,Obstetrics and Gynecology, The Ohio State University Wexner Medical Center,The Heart Center, Nationwide Children’s Hospital, Columbus, OH
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24
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Cameron KL, FitzGerald TL, Albesher RA, McGinley JL, Allison K, Lee KJ, Cheong JLY, Spittle AJ. Barriers and facilitators to community participation for preschool age children born very preterm: a prospective cohort study. Dev Med Child Neurol 2021; 63:675-682. [PMID: 33421112 DOI: 10.1111/dmcn.14809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 12/15/2022]
Abstract
AIM We compared preschool age children born very preterm with term-born controls to: (1) understand the association between very preterm birth and community participation, (2) determine if motor impairment or social risk affect participation differently between groups, and (3) understand environmental barriers and supports to participation for parents. METHOD Forty-eight children born very preterm (<30wks' gestation; 22 males, 26 females) and 96 controls (47 males, 49 females) were assessed at 4 to 5 years' corrected age for community participation using the Young Children's Participation and Environment Measure. Motor skills were assessed using the Movement Assessment Battery for Children, Second Edition and the Little Developmental Coordination Disorder Questionnaire. RESULTS Children born very preterm participated less frequently than term-born children (difference in means=-0.28, 95% confidence interval [CI] -0.54 to -0.03, p=0.029). Social risk was associated with lower frequency (interaction p<0.001) and involvement (interaction p=0.05) in community activities for children in the very preterm group only. Parents of children born very preterm perceived more barriers (odds ratio=4.32, 95% CI 1.46-12.77, p=0.008) and environmental factors to be less supportive of participation than parents of controls (difference in medians=-6.21, 95% CI -11.42 to -1.00, p=0.02). INTERPRETATION Children born very preterm may benefit from ongoing support to promote participation, especially in families of higher social risk.
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Affiliation(s)
- Kate L Cameron
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Tara L FitzGerald
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Reem A Albesher
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia.,Physiotherapy Department, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Jennifer L McGinley
- Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia
| | - Kim Allison
- Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine J Lee
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
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25
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Ma RH, Zhang Q, Ni ZH, Lv HT. Transitional care experiences of caregivers of preterm infants hospitalized in a neonatal intensive care unit: A qualitative descriptive study. Nurs Open 2021; 8:3484-3494. [PMID: 33951349 PMCID: PMC8510728 DOI: 10.1002/nop2.899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/18/2021] [Accepted: 03/29/2021] [Indexed: 11/08/2022] Open
Abstract
Aim To describe the transitional care experiences and nursing needs of caregivers of preterm infants hospitalized in neonatal intensive care units (NICUs). Design A qualitative descriptive study. Methods We conducted semi‐structured interviews with the 24 caregivers of preterm infants admitted to Children's Hospital, Soochow University. All data were collected by a trained and experienced interviewer. The caregivers' experiences were described using qualitative content analysis. Results Six Five themes emerged from the analysis: (a) uncertainty about the disease; (b) anxiety due to restricted visitation; (c) exhaustion from overwork; (d) emotional depression; (e) low care ability; (f) a variety of channels for help and a positive response. This study provides a basis for understanding the needs of their caregivers so that effective coping strategies can be implemented. Nurses' education and practice should focus on understanding the real experiences of the parents of preterm infants during transitional nursing.
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Affiliation(s)
- Ruo Han Ma
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China.,Medical College of Soochow University, Suzhou, China
| | - Qing Zhang
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China
| | - Zhi Hong Ni
- Nursing Department, Children's Hospital of Soochow University, Suzhou, China
| | - Hai Tao Lv
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China
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26
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Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis. Harv Rev Psychiatry 2021; 29:196-215. [PMID: 33979106 DOI: 10.1097/hrp.0000000000000294] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention). METHODS We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number. RESULTS 295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features. CONCLUSION Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.
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27
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Seppänen AV, Sauvegrain P, Draper ES, Toome L, El Rafei R, Petrou S, Barros H, Zimmermann LJI, Cuttini M, Zeitlin J. Parents' ratings of post-discharge healthcare for their children born very preterm and their suggestions for improvement: a European cohort study. Pediatr Res 2021; 89:1004-1012. [PMID: 32947602 DOI: 10.1038/s41390-020-01120-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Follow-up of very preterm infants is essential for reducing risks of health and developmental problems and relies on parental engagement. We investigated parents' perceptions of post-discharge healthcare for their children born very preterm in a European multi-country cohort study. METHODS Data come from a 5-year follow-up of an area-based cohort of births <32 weeks' gestation in 19 regions from 11 European countries. Perinatal data were collected from medical records and 5-year data from parent-report questionnaires. Parents rated post-discharge care related to their children's preterm birth (poor/fair/good/excellent) and provided free-text suggestions for improvements. We analyzed sociodemographic and medical factors associated with poor/fair ratings, using inverse probability weights to adjust for attrition bias, and assessed free-text responses using thematic analysis. RESULTS Questionnaires were returned for 3635 children (53.8% response rate). Care was rated as poor/fair for 14.2% [from 6.1% (France) to 31.6% (Denmark)]; rates were higher when children had health or developmental problems (e.g. cerebral palsy (34.4%) or epilepsy (36.9%)). From 971 responses, 4 themes and 25 subthemes concerning care improvement were identified. CONCLUSIONS Parents' experiences provide guidance for improving very preterm children's post-discharge care; this is a priority for children with health and developmental problems as parental dissatisfaction was high. IMPACT In a European population-based very preterm birth cohort, parents rated post-discharge healthcare as poor or fair for 14.2% of children, with a wide variation (6.1-31.6%) between countries. Dissatisfaction was reported in over one-third of cases when children had health or developmental difficulties, such as epilepsy or cerebral palsy. Parents' free-text suggestions for improving preterm-related post-discharge healthcare were similar across countries; these focused primarily on better communication with parents and better coordination of care. Parents' lived experiences are a valuable resource for understanding where care improvements are needed and should be included in future research.
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Affiliation(s)
- Anna-Veera Seppänen
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, 75004, Paris, France.
- Sorbonne Université Collège Doctoral, 75005, Paris, France.
| | - Priscille Sauvegrain
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, 75004, Paris, France
- Department of Obstetrics and Gynecology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | | | - Liis Toome
- Tallinn Children's Hospital, Tallinn, Estonia
- University of Tartu, Tartu, Estonia
| | - Rym El Rafei
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, 75004, Paris, France
- Sorbonne Université Collège Doctoral, 75005, Paris, France
| | - Stavros Petrou
- Warwick Medical School, University of Warwick, Coventry, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Luc J I Zimmermann
- European Foundation for the Care of Newborn Infants (EFCNI), Munich, Germany
- Department of Paediatrics, Research School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands
| | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, Rome, Italy
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, 75004, Paris, France
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Cheong J, Cameron KLI, Thompson D, Anderson PJ, Ranganathan S, Clark R, Mentiplay B, Burnett A, Lee K, Doyle LW, Spittle AJ. Impact of moderate and late preterm birth on neurodevelopment, brain development and respiratory health at school age: protocol for a longitudinal cohort study (LaPrem study). BMJ Open 2021; 11:e044491. [PMID: 33518527 PMCID: PMC7852967 DOI: 10.1136/bmjopen-2020-044491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Children born moderate to late preterm (MLP, 32-36 weeks' gestation) account for approximately 85% of all preterm births globally. Compared with children born at term, children born MLP are at increased risk of poor neurodevelopmental outcomes. Despite making up the largest group of preterm children, developmental outcomes of children born MLP are less well studied than in other preterm groups. This study aimed to (1) compare neurodevelopmental, respiratory health and brain magnetic resonance imaging (MRI) outcomes between children born MLP and term at 9 years of age; (2) examine the differences in brain growth trajectory from infancy to 9 years between children born MLP and term; and in children born MLP; (3) examine the relationship between brain development and neurodevelopment at 9 years; and (4) identify risk factors for poorer outcomes at 9 years. METHODS AND ANALYSIS The "LaPrem" (Late Preterm MRI Study) study is a longitudinal cohort study of children born MLP and term controls, born at the Royal Women's Hospital in Melbourne, Australia, between 2010 and 2013. Participants were recruited in the neonatal period and were previously followed up at 2 and 5 years. This 9-year school-age follow-up includes neuropsychology, motor and physical activities, and lung function assessments, as well as brain MRI. Outcomes at 9 years will be compared between birth groups using linear and logistic regressions. Trajectories of brain development will be compared between birth groups using mixed effects models. The relationships between MRI and neurodevelopmental outcomes, as well as other early predictors of poor 9-year outcomes, will be explored using linear and logistic regression. ETHICS AND DISSEMINATION This study was approved by the human research ethics committee at the Royal Children's Hospital, Melbourne, Australia. Study outcomes will be disseminated through peer-reviewed publications, conference presentations and social media.
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Affiliation(s)
- Jeanie Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Lillian Iona Cameron
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Deanne Thompson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Peter J Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
- Respiratory Diseases, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Ross Clark
- Research Health Institute, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Benjamin Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Alice Burnett
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Katherine Lee
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Lex William Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alicia J Spittle
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
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Abstract
Interventions are needed to enhance early development and minimise long-term impairments for children born very preterm (VP, <32 weeks' gestation) and their families. Given the role of the environment on the developing brain, the potential for developmental interventions that modify the infant's hospital and home environments to improve outcomes is high. Although early developmental interventions vary widely in focus, timing, and mode of delivery, evidence generally supports the effectiveness of these programs to improve specific outcomes for children born VP and their families. However, little is known about mechanisms for effectiveness, cost- and long-term effectiveness, which programs might work better for whom, and how to provide early intervention services equitably. This information is critical to facilitate systematic integration of effective developmental interventions into clinical care for infants born very preterm and their families.
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30
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Burnett A, Spittle A. Early intervention starting in the neonatal nursery to improve child development. Acta Paediatr 2020; 109:1071-1072. [PMID: 31997400 DOI: 10.1111/apa.15147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Ferreira RDC, Alves CRL, Guimarães MAP, Menezes KKPD, Magalhães LDC. Effects of early interventions focused on the family in the development of children born preterm and/or at social risk: a meta‐analysis. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2019.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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32
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Ferreira RDC, Alves CRL, Guimarães MAP, Menezes KKPD, Magalhães LDC. Effects of early interventions focused on the family in the development of children born preterm and/or at social risk: a meta-analysis. J Pediatr (Rio J) 2020; 96:20-38. [PMID: 31254528 PMCID: PMC9432118 DOI: 10.1016/j.jped.2019.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/11/2019] [Accepted: 05/06/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To verify whether early intervention focused on the family improves the cognitive, motor, and language development of children born preterm and/or at social risk in the first 3 years of life. SOURCE OF DATA Meta-analysis of clinical trials published between 2008 and 2018, in the following databases: CINAHL, MEDLINE - PubMed, MEDLINE - BVS, LILACS - BVS, IBECS - BVS, PEDro and Cochrane Reviews. Experimental studies on early interventions focused on the family, whose target groups were children born preterm and/or at social risk, with assessment of cognitive and/or motor and/or language development up to 3 years were included. The studies were rated using the PEDro Scale. DATA SYNTHESIS Twelve studies were included from a total of 3378 articles. Early intervention focused on the family contributed to the development of the cognitive (Standardized Mean Difference - SMD=0.48, 95% CI: 0.34-0.61) and motor (SMD=0.76, 95% CI: 0.55-0.96) domains of preterm infants. Regarding cognitive development, performance improvement was observed at 12, 24 and 36 months, while in the motor domain, the effect was observed only at 12 months in preterm infants. There was no benefit of the intervention in the cognitive, motor, and language outcomes of children with the social risk factor associated to biological risk. CONCLUSION Early intervention focused on the family has a positive effect on the cognition of preterm infants. The effect on motor development was lower, possibly due to the emphasis on interventions in family-child interaction. The effect of interventions on the development of children at social risk and on the language domain was inconclusive, due to the scarcity of studies in the area.
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Affiliation(s)
| | - Claudia Regina Lindgren Alves
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Marina Aguiar Pires Guimarães
- Universidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Ciências da Saúde - Saúde da Criança e do Adolescente, Belo Horizonte, MG, Brazil
| | - Kênia Kiefer Parreiras de Menezes
- Universidade Federal de Minas Gerais (UFMG), Escola Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Fisioterapia, Belo Horizonte, MG, Brazil
| | - Lívia de Castro Magalhães
- Universidade Federal de Minas Gerais (UFMG), Escola Educação Física, Fisioterapia e Terapia Ocupacional (EEFFTO), Departamento de Terapia Ocupacional, Belo Horizonte, MG, Brazil
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33
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Cheong JLY, Burnett AC, Treyvaud K, Spittle AJ. Early environment and long-term outcomes of preterm infants. J Neural Transm (Vienna) 2019; 127:1-8. [PMID: 31863172 DOI: 10.1007/s00702-019-02121-w] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/11/2019] [Indexed: 12/27/2022]
Abstract
Prematurity is associated with an increased risk of long-term health and neurodevelopmental problems. Key perinatal and neonatal factors that affect these outcomes have long been studied. However, more recently, there has been an appreciation of the importance of environmental factors in long-term outcomes of preterm babies, particularly in light of the rapid maturation of the brain during these babies' early days of life. Breastmilk and breastfeeding is the gold standard for infant feeding, including preterm babies. The benefits are well established in regard to protection from serious complications like necrotising enterocolitis. Although theoretically plausible, the benefits for neurodevelopment are less clear. Noise, pain and the environment of the neonatal intensive care can also affect infant neurodevelopment. It is established that noise and pain have deleterious effects. However, the benefits of single-room vs open-bay neonatal units remain under debate. Developmental care practices, of which there are many, are increasingly embraced worldwide. There are benefits both for the parents and the baby, however, the evidence is difficult to pool due to the heterogeneity of studies and study populations. Finally, it is important to remember the importance of the role of parents in shaping long-term neurodevelopment of the high-risk preterm newborn. Increasingly, positive parenting and parents' mental health are shown to have long lasting advantages for preterm infants. A deeper understanding of early environmental factors is key to developing future interventions to optimise outcomes of preterm newborns.
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Affiliation(s)
- Jeanie L Y Cheong
- Level 7, Newborn Research, Royal Women's Hospital, 20 Flemington Road, Parkville, VIC, 3052, Australia.
| | - Alice C Burnett
- Level 4, Victorian Infant Brain Studies, Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Karli Treyvaud
- Department of Psychology and Counselling, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Alicia J Spittle
- Level 7, Department of Physiotherapy, University of Melbourne, 161 Barry Street, Parkville, VIC, 3052, Australia
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Ouwendijk-Andréa M, Bröring-Starre T, Molderink AC, Laarman CARC, Oostrom KJ, van Dijk-Lokkart EM. Parental emotional distress after discharge from the neonatal intensive care unit: A pilot study. Early Hum Dev 2019; 140:104892. [PMID: 31715521 DOI: 10.1016/j.earlhumdev.2019.104892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Mieke Ouwendijk-Andréa
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands.
| | - Tinka Bröring-Starre
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands
| | - Alice C Molderink
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands; Psychosocial Department, Emma Children's Hospital/Amsterdam University Medical Centers, the Netherlands
| | - Céleste A R C Laarman
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands; Department of Neonatology, Amsterdam University Medical Centers, the Netherlands
| | - Kim J Oostrom
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands; Psychosocial Department, Emma Children's Hospital/Amsterdam University Medical Centers, the Netherlands
| | - Elisabeth M van Dijk-Lokkart
- Departments of Medical Psychology, Amsterdam University Medical Centers, the Netherlands; Psychosocial Department, Emma Children's Hospital/Amsterdam University Medical Centers, the Netherlands
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35
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Seppänen AV, Bodeau-Livinec F, Boyle EM, Edstedt-Bonamy AK, Cuttini M, Toome L, Maier RF, Cloet E, Koopman-Esseboom C, Pedersen P, Gadzinowski J, Barros H, Zeitlin J. Specialist health care services use in a European cohort of infants born very preterm. Dev Med Child Neurol 2019; 61:832-839. [PMID: 30508225 DOI: 10.1111/dmcn.14112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2018] [Indexed: 12/27/2022]
Abstract
AIM Children born very preterm require additional specialist care because of the health and developmental risks associated with preterm birth, but information on their health service use is sparse. We sought to describe the use of specialist services by children born very preterm in Europe. METHOD We analysed data from the multi-regional, population-based Effective Perinatal Intensive Care in Europe (EPICE) cohort of births before 32 weeks' gestation in 11 European countries. Perinatal data were abstracted from medical records and parents completed a questionnaire at 2 years corrected age (4322 children; 2026 females, 2296 males; median gestational age 29wks, interquartile range [IQR] 27-31wks; median birthweight 1230g, IQR 970-1511g). We compared parent-reported use of specialist services by country, perinatal risk (based on gestational age, small for gestational age, and neonatal morbidities), maternal education, and birthplace. RESULTS Seventy-six per cent of the children had consulted at least one specialist, ranging across countries from 53.7% to 100%. Ophthalmologists (53.4%) and physiotherapists (48.0%) were most frequently consulted, but individual specialists varied greatly by country. Perinatal risk was associated with specialist use, but the gradient differed across countries. Children with more educated mothers had higher proportions of specialist use in three countries. INTERPRETATION Large variations in the use of specialist services across Europe were not explained by perinatal risk and raise questions about the strengths and limits of existing models of care. WHAT THIS PAPER ADDS Use of specialist services by children born very preterm varied across Europe. This variation was observed for types and number of specialists consulted. Perinatal risk was associated with specialist care, but did not explain country-level differences. In some countries, mothers' educational level affected use of specialist services.
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Affiliation(s)
- Anna-Veera Seppänen
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Statistics, Sorbonne Paris Cité, Paris, France.,Collège Doctoral, Sorbonne Université, Paris, France
| | - Florence Bodeau-Livinec
- Ecole des Hautes Etudes en Santé Publique, Rennes, France.,DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Elaine M Boyle
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Anna-Karin Edstedt-Bonamy
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, Rome, Italy
| | - Liis Toome
- Tallinn Children's Hospital, Tallinn, Estonia.,University of Tartu, Tartu, Estonia
| | - Rolf F Maier
- Children's Hospital, University Hospital, Philipps University Marburg, Marburg, Germany
| | - Eva Cloet
- Public Health, Vrije Universiteit Brussel Faculteit Geneeskunde en Farmacie, Brussels, Belgium.,Paediatric Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Corine Koopman-Esseboom
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | | | - Janusz Gadzinowski
- Department of Neonatology, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Jennifer Zeitlin
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Statistics, Sorbonne Paris Cité, Paris, France
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36
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Child Motivation and Family Environment Influence Outcomes of Working Memory Training in Extremely Preterm Children. JOURNAL OF COGNITIVE ENHANCEMENT 2019. [DOI: 10.1007/s41465-019-00138-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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37
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Nurturing the preterm infant brain: leveraging neuroplasticity to improve neurobehavioral outcomes. Pediatr Res 2019; 85:166-175. [PMID: 30531968 DOI: 10.1038/s41390-018-0203-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 12/19/2022]
Abstract
An intrinsic feature of the developing brain is high susceptibility to environmental influence-known as plasticity. Research indicates cascading disruption to neurological development following preterm (PT) birth; yet, the interactive effects of PT birth and plasticity remain unclear. It is possible that, with regard to neuropsychological outcomes in the PT population, plasticity is a double-edged sword. On one side, high plasticity of rapidly developing neural tissue makes the PT brain more vulnerable to injury resulting from events, including inflammation, hypoxia, and ischemia. On the other side, plasticity may be a mechanism through which positive experience can normalize neurological development for PT children. Much of the available literature on PT neurological development is clinically weighted and focused on diagnostic utility for predicting long-term outcomes. Although diagnostic utility is valuable, research establishing neuroprotective factors is equally beneficial. This review will: (1) detail specific mechanisms through which plasticity is adaptive or maladaptive depending on the experience; (2) integrate research from neuroimaging, intervention, and clinical science fields in a summary of findings suggesting inherent plasticity of the PT brain as a mechanism to improve child outcomes; and (3) summarize how responsive caregiving experiences situate parents as agents of change in normalizing PT infant brain development.
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38
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Anderson PJ. Classifying High-risk Children Born Preterm. Paediatr Perinat Epidemiol 2018; 32:126-128. [PMID: 29336061 DOI: 10.1111/ppe.12440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Peter J Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Victoria, Australia
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39
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Pelc K, Gajewska A. Early intervention and environmental factors: optimizing the development of infants born preterm. Dev Med Child Neurol 2018; 60:7. [PMID: 29139547 DOI: 10.1111/dmcn.13626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Karine Pelc
- Department of Paediatrics, CHU Saint-Pierre, Université libre de Bruxelles, Brussels, Belgium.,Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
| | - Aleksandra Gajewska
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
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