Randomised trial of a parenting intervention during neonatal intensive care
Abstract
Objective: To evaluate impact of parenting intervention on maternal responsiveness and infant neurobehavioural development following a very premature birth.
Design: Cluster-randomised controlled trial, with a crossover design and 3 month washout period.
Setting: Six neonatal intensive care units (NICUs).
Patients: Infants born <32 weeks gestation.
Intervention: The Parent Baby Interaction Programme is a supportive, educational intervention delivered by research nurses in the NICU, with optional home follow-up for up to 6 weeks after discharge.
Main outcome measures: Parenting stress at 3 months adjusted age, as measured by the Parenting Stress Index. Other outcomes included the Neurobehavioral Assessment of the Preterm Infant and maternal interaction as assessed by the Nursing Child Assessment Teaching Scale and the responsivity subscale for Home Observation for Measurement of the Environment (HOME).
Results: A total of 112 infants were recruited in the intervention phases and 121 in the control phases. Mean standardised NAPI scores at 35 weeks did not differ between the groups. Both groups had low but similar NCATS caregiver scores prior to discharge (36.6 in the PBIP group and 37.4 in control, adjusted mean difference -0.7, 95% CI -2.7 to 1.4). At three months adjusted age mean PSI scores for the PBIP group were 71.9 compared to 67.1 for controls (adjusted mean difference 4.0, 95% CI -3.7 to 11.8). NCATS scores and HOME responsivity scores were similarly distributed between groups .
Conclusions: This early, nurse-delivered, parent- focused interaction programme had no measurable effects on short term infant neurobehavioural function, mother- child interaction or parenting stress.
