Patterned feeding experience for preterm infants: study protocol for a randomized controlled trial.
Patterned feeding experience for preterm infants: study protocol for a randomized controlled trial.
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DOI：
10.1186/s13063-015-0781-3
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发表时间：
2015-06-04
期刊：
影响因子：
2.5
通讯作者：
Moore M
中科院分区：
文献类型：
--
作者：
Pickler RH;Wetzel PA;Meinzen-Derr J;Tubbs-Cooley HL;Moore M
神经行为障碍发生在5%-15%的早产儿中，估计有50%-70%的极低出生体重早产儿后来经历功能障碍，包括认知、行为和社交延迟，通常持续到成年。与神经行为和发育结局不良有关的因素是新生儿重症监护病房(NICU)的住院和不一致的护理模式。虽然许多潜在的脑损伤发生在宫内或出生后不久，但神经保护策略可以阻止损伤的进展，特别是在足月前几个月神经可塑性最敏感的时期使用这些策略时。这项随机试验的目的是测试模式化喂养体验对早产儿神经行为组织和发育、认知功能和临床结果的影响。本试验采用试验性、纵向、两组设计，共120名早产儿。婴儿在出生的第一周内被登记，并被随机分成从第一次灌胃喂养到出院接受模式喂养体验的试验组，或接受常规喂养护理体验的对照组。干预包括与喂养相关的触觉体验的连续性，以训练和建立支持正常婴儿喂养体验的神经网络。主要结果是通过早产儿神经行为评估在3个时间点测量的神经行为组织：过渡到口服喂养、NICU出院和2个月校正年龄。次要目标是使用贝利婴幼儿发展量表第三版在校正年龄6个月时测量认知功能、神经行为发展(吸吮组织、喂养性能和心率变异性)和临床结果(NICU住院时间和完全口服喂养的时间)。还将考虑人口统计和生物行为因素(围产期事件和母体或胎儿/新生儿来源的状况以及免疫和遗传生物标记物)对结果变量的潜在影响。从理论上讲，在神经系统发育的关键时刻提供干预，并与反复发生的事件(进食)相关，应该会增强神经连接，这对以后的发育可能是重要的，特别是语言和其他认知和神经行为组织技能。NCT01577615 2012年4月11日。本文的在线版本(doi：10.1186/s13063-0150781-3)包含补充材料，授权用户可以使用。
Neurobehavioral disabilities occur in 5–15 % of preterm infants with an estimated 50–70 % of very low birth weight preterm infants experiencing later dysfunction, including cognitive, behavioral, and social delays that often persist into adulthood. Factors implicated in poor neurobehavioral and developmental outcomes are hospitalization in the neonatal intensive care unit (NICU) and inconsistent caregiving patterns. Although much underlying brain damage occurs in utero or shortly after birth, neuroprotective strategies can stop lesions from progressing, particularly when these strategies are used during the most sensitive periods of neural plasticity occurring months before term age. The purpose of this randomized trial is to test the effect of a patterned feeding experience on preterm infants’ neurobehavioral organization and development, cognitive function, and clinical outcomes. This trial uses an experimental, longitudinal, 2-group design with 120 preterm infants. Infants are enrolled within the first week of life and randomized to an experimental group receiving a patterned feeding experience from the first gavage feeding through discharge or to a control group receiving usual feeding care experience. The intervention involves a continuity of tactile experiences associated with feeding to train and build neuronal networks supportive of normal infant feeding experience. Primary outcomes are neurobehavioral organization as measured by Neurobehavioral Assessment of the Preterm Infant at 3 time points: the transition to oral feedings, NICU discharge, and 2 months corrected age. Secondary aims are cognitive function measured using the Bayley Scales of Infant and Toddler Development, Third Edition at 6 months corrected age, neurobehavioral development (sucking organization, feeding performance, and heart rate variability), and clinical outcomes (length of NICU stay and time to full oral feeding). The potential effects of demographic and biobehavioral factors (perinatal events and conditions of maternal or fetal/newborn origin and immunologic and genetic biomarkers) on the outcome variables will also be considered. Theoretically, the intervention provided at a critical time in neurologic system development and associated with a recurring event (feeding) should enhance neural connections that may be important for later development, particularly language and other cognitive and neurobehavioral organization skills. NCT01577615 11 April 2012. The online version of this article (doi:10.1186/s13063-015-0781-3) contains supplementary material, which is available to authorized users.
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影响因子：
168.9
作者：
Mwaniki, Michael K.;Atieno, Maurine;Lawn, Joy E.;Newton, Charles R. J. C.
通讯作者：
Newton, Charles R. J. C.
影响因子：
8
作者：
Als, H;Duffy, FH;Eichenwald, EC
通讯作者：
Eichenwald, EC
影响因子：
2.1
作者：
Graven, SN
通讯作者：
Graven, SN
影响因子：
3.8
作者：
Lau, C;Schanler, RJ
通讯作者：
Schanler, RJ
影响因子：
3.6
作者：
BALDZER, K;DYKES, FD;GIDDENS, DP
通讯作者：
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