Family Nurture Intervention in the Neonatal Intensive Care Unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial
Family Nurture Intervention in the Neonatal Intensive Care Unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial
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DOI：
10.1111/jcpp.12405
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发表时间：
2015-11-01
影响因子：
7.6
通讯作者：
Myers, Michael M.
中科院分区：
文献类型：
--
作者：
Welch, Martha G.;Firestein, Morgan R.;Myers, Michael M.
背景：早产儿是神经发育和行为不良后果的高危人群。新生儿重症监护室的家庭养育干预旨在消除母亲与早产儿分离的不利影响。在这里，我们评估FNI对神经行为结果的影响。方法：在18个月矫正年龄时收集早产儿的数据。婴儿一出生就被分配到民族阵线或标准护理。对76名婴儿（SC，n = 31; FNI，n = 45）进行了Bayley婴儿发育量表III（Bayley-III）评估;对57名婴儿（SC，n = 31; FNI，n = 26）进行了儿童行为量表（CBCL）评估;对59名婴儿（SC，n = 33; FNI，n = 26）进行了改良的幼儿自闭症量表（M-CHAT）评估。结果如下：家庭养育干预显著改善了Bayley-III认知（p = 0.039）和语言（p = 0.008）得分大于85的婴儿。FNI婴儿在CBCL上的注意力问题较少（p <0.02）。FNI改善了总的M-CHAT评分（p <0.02）。76%的SC婴儿至少有一项M-CHAT项目不及格，而FNI婴儿的这一比例为27%（p < .001）。此外，36%的SC婴儿与0%的FNI婴儿在至少一项社会关系M-CHAT项目中失败（p <0.001）。结论：家庭养育干预是第一个NICU干预，在神经发育，社会关系和注意力问题的多个领域显示出早产儿的显着改善。这些成果表明，促进新生儿重症监护室中母亲和婴儿之间情感互动的干预措施可能是改变早产儿发育轨迹的关键。
Background: Preterm infants are at high risk for adverse neurodevelopmental and behavioral outcomes. Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) is designed to counteract adverse effects of separation of mothers and their preterm infants. Here, we evaluate effects of FNI on neurobehavioral outcomes. Methods: Data were collected at 18 months corrected age from preterm infants. Infants were assigned at birth to FNI or standard care (SC). Bayley Scales of Infant Development III (Bayley-III) were assessed for 76 infants (SC, n = 31; FNI, n = 45); the Child Behavior Checklist (CBCL) for 57 infants (SC, n = 31; FNI, n = 26); and the Modified Checklist for Autism in Toddlers (M-CHAT) was obtained for 59 infants (SC, n = 33; FNI, n = 26). Results: Family Nurture Intervention significantly improved Bayley-III cognitive (p = .039) and language (p = .008) scores for infants whose scores were greater than 85. FNI infants had fewer attention problems on the CBCL (p < .02). FNI improved total M-CHAT scores (p < .02). Seventy-six percent of SC infants failed at least one of the M-CHAT items, compared to 27% of FNI infants (p < .001). In addition, 36% of SC infants versus 0% of FNI infants failed at least one social-relatedness M-CHAT item (p < .001). Conclusions: Family Nurture Intervention is the first NICU intervention to show significant improvements in preterm infants across multiple domains of neurodevelopment, social-relatedness, and attention problems. These gains suggest that an intervention that facilitates emotional interactions between mothers and infants in the NICU may be key to altering developmental trajectories of preterm infants.