No Change in Developmental Outcome with Incubator Covers and Nesting for Very Preterm Infants in a Randomized Controlled Trial
- Paul H.T. van Zwieten (p.vanzwieten{at}hagaziekenhuis.nl)
Abstract
Objective: Randomized controlled trial investigating effect of basic elements of developmental care (DC) (incubator covers and positioning aids) on growth and neurodevelopment in infants born <32 weeks.
Method: Infants were randomized within 48 hours of birth to DC group or standard care (C) group. Outcome measures at 1 and 2 years corrected age (CA) were growth, standardized neurological exams and mental (MDI) and psychomotor (PDI) development (Dutch version of the Bayley Scales of Infant Development II).
Results: 192 infants were recruited (DC=98; C=94). Thirteen infants (DC=7, C=6) were excluded because they were admitted less than or died within the first 5 days. In total, 179 infants met inclusion criteria. In-hospital mortality was 12/91 (13.2%) in DC group and 8/88 (9.1%) in C group. 147 children (DC= 74, C= 73) at 1 year and 142 children (DC=72, C=70) at 2 years were assessed. No significant difference in growth, neurological outcomes or MDI was found. A positive trend in PDI at 1 year (p=0.05) did not continue once the children reached 2 years. There was no difference found when neurological and developmental scores were combined.
Conclusions: Basic developmental care has no positive effect on neurological and mental development or growth at 1 and 2 years in infants born < 32 weeks. A positive effect on psychomotor development at 1 year did not continue at 2 years of age.
