Is the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) effective for preterm infants with intrauterine growth restriction?

Abstract

Objective This study investigates the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) on neurobehavioral and electrophysiological functioning of preterm infants with severe intrauterine growth restriction (IUGR). Study Design Thirty IUGR infants, 28 to 33 weeks gestational age, randomized to standard care (control/C = 18), or NIDCAP (experimental/E = 12), were assessed at 2 weeks corrected age (2wCA) and 9 months corrected age (9mCA) in regard to health, anthropometrics, and neurobehavior, and additionally at 2wCA in regard to electrophysiology (EEG). Result The two groups were comparable in health and anthropometrics at 2wCA and 9mCA. The E-group at 2wCA showed significantly better autonomic, motor, and self-regulation functioning, improved motility, intensity and response thresholds, and reduced EEG connectivity among several adjacent brain regions. At 9mCA, the E-group showed significantly better mental performance. Conclusion This is the first study to show NIDCAP effectiveness for IUGR preterm infants.

The Effects of Developmental Care on Short-Term Outcomes of Preterm Infants: A Quasi-Experimental Study

“…An explanation for various results of these studies could be the flexible decisionmaking about the type of respiratory support in our study, the difference in applied interventions, and the variety in neonates' basic details. This study confirms the findings of Maguire et al (2008) and Als et al (2011) regarding the similarity of the neonates' growth parameters at term age between control and intervention groups (7,31). On the contrary, Borimnejad et al (2013) showed that empowering programs for mothers of preterm infants can increase weight gain in intervention group after 2 month (32).…”

Riesgo neurológico en el niño de mediano riesgo neonatal

“…Si bien estas prác-ticas son aceptadas e implementadas en muchas Unidades de Cuidado Intensivo Neonatal aún es discutida su efectividad sobre el neurodesarrollo a largo plazo. 52,53 Una cuestión central es hasta qué punto es posible reducir la morbilidad neurológica en los neonatos de mediano riesgo. Parecería que aún se está lejos de lograr este objetivo puesto que los factores de riesgo no siempre son adecuadamente controlados.…”

Authors’ Response: NIDCAP: A Systematic Review and Meta-analyses of Randomized Controlled Trials

“…1 These include the exceedingly long time lapses between recruitment and publication of the results, 14 trial registration in all included studies only after the last patient was recruited, and in Dr Als and co-workers' 2 latest studies an unexplained imbalance between the numbers of infants randomized to the NIDCAP and the control groups. 33,34 In the 2011 report there were 12 infants in the NIDCAP group and 18 in the control group. 33 In the 2012 report there were 13 infants in the NIDCAP group and 17 in the control group.…”

“…33,34 In the 2011 report there were 12 infants in the NIDCAP group and 18 in the control group. 33 In the 2012 report there were 13 infants in the NIDCAP group and 17 in the control group. 34 Did the difference of 10 more infants enrolled in the control groups than in the NIDCAP groups in these very small trials happen by chance?…”

“…As researchers conducting meta-analyses, we have to be careful not to include outcome data from the same infant twice, but this has been difficult. More recently, the 9-year outcomes were published for 23 infants from the 2011 report 33 (9 children in the NIDCAP group and 14 in the control group; 23% lost to follow-up). 29 The study has the same NCT number (NCT00914108) as the 2 previous studies from 2011 33 and 2012.…”