Preventive Intervention Program on the Outcomes of Very Preterm Infants and Caregivers: A Multicenter Randomized Controlled Trial

Youn, Young Ah; Shin, Seung Han; Kim, Ee Kyung; Jin, Hye Jeong; Jung, Young Hwa; Heo, Ju Sun; Jeon, Ji Hyun; Park, Joo Hyun; Sung, In Kyung

doi:10.3390/brainsci11050575

Cited by 12 publications

(21 citation statements)

References 41 publications

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“…During a weeklong observation period of maternal touch, the average maternal self-confidence score decreased. This is in accordance with previous findings suggesting that various stresses experienced by mothers of HRIs result in maternal role tension and negative emotional and psychological effects in early maternal role attainment [6,7]. It could be inferred that physical separation resulting from the baby's admission to the NICU interrupts emotional exchanges and that mothers who have reduced opportunities to interact with and take care of their infants may be vulnerable to maternal role attainment.…”

Section: Discussionsupporting

confidence: 92%

“…As Trumello et al [5] asserted, mothers of HRIs regard labor as a negative experience, involving feelings of fear, anxiety, helplessness, and panic. As admission to the NICU is an event that affects both mothers and HRIs, the stress resulting from the NICU environment causes tension and negative emotional and psychological effects during the initial maternal role attainment process, thereby lowering self-confidence [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Maternal Touch, Maternal Self-Confidence, Infant Length, and Feeding Volume in High-Risk Infants: Touch on the Mind

Jang¹,

Han²

2022

STRESS

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Background: Childbirth is a physical and emotional experience. In particular, mothers of high-risk infants often exhibit low maternal self-confidence. Through interactions in the form of touch, maternal sensory stimulation provides comfort for both mother and baby. This study aims to investigate the association between maternal touch in the early postpartum period and the growth of infants as well as maternal self-confidence.Methods: Thirty-six mother-infant dyads in a level III-IV Neonatal Intensive Care Unit (NICU) were analyzed. Maternal touch on various body parts (extremities, face/head, and trunk) was observed, and infant length and feeding volume were assessed by direct measurement of the medical records. Maternal self-confidence was assessed using a questionnaire. Along with descriptive statistics, we conducted correlation and Mann-Whitney U tests.Results: Although maternal self-confidence decreased over time, that of mothers with a high level of contact with the infant’s face/head or extremities decreased significantly less than that of mothers in the low-contact group. For the baby, the feeding volume of infants with a high degree of maternal contact on their extremities or trunk increased significantly compared with that of the low-contact group.Conclusions: Mothers’ self-confidence may not improve as the infant grows, but can be strengthened by enhanced touch on the infant’s face/head. Touching the infant’s trunk is related to infant feeding. The research findings emphasize the importance of early maternal touch in the NICU environment and recommend the provision of maternal touch to appropriate body parts to achieve the desired objectives.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Relationship between Maternal Touch, Maternal Self-Confidence, Infant Length, and Feeding Volume in High-Risk Infants: Touch on the Mind

Jang¹,

Han²

2022

STRESS

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“…There was no evidence of effect on motor development at 10 months corrected age in one RCT (42) (n=136, MD 0.20, 95% CI 4.47 to 4.07) or infant temperament (21) (n=161, MD 0.70, 95% CI −0.6 to 1.46) at six months corrected age.…”

Section: Resultsmentioning

confidence: 96%

“…Nine home visiting studies comprised of interventions which commenced and continued in the home following birth (30–42). Parents were supported in aspects of their infants’ care including care planning in the home, sensitivity and responsiveness, promotion of infant development and breastfeeding.…”

Section: Resultsmentioning

confidence: 99%

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Interventions to support parents, families and caregivers in caring for preterm or low birth weight infants at home: a systematic review

Bedwell

Danna

Tate

et al. 2022

Preprint

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Background: Preterm and low birth weight (LBW) (<2500g) infants are at greater risk of mortality and morbidity. Interventions to support parents to care for their newborn infant in the home may help to improve outcomes. Objective: To determine what interventions, approaches, or strategies to support mothers/fathers/caregivers and families in caring for preterm or LBW infants in the home have been effective in improving outcomes. Methods: A comprehensive search of relevant electronic databases, including MEDLINE, Embase, CINAHL and Cochrane Central Register of Controlled Trials was completed in September 22. Two reviewers screened papers in Covidence and extracted data from 41 included papers. Quality of papers and certainty of evidence were assessed using CASP and GRADE, respectively. Results: There is some evidence that support interventions may improve outcomes related to infant mortality, improvements in infant growth, exclusive breastfeeding, infant cognitive development, immunisation uptake, and reduction in maternal stress and depression. However, the overall certainty of evidence is low or very low in the majority of studies. Conclusions: Interventions providing support for parents to care for infants in the home may improve outcomes for this population. There is a need for well-considered large scale support interventions, prioritised and developed with women and families.

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Music Therapy in Infancy and Neurodevelopmental Outcomes in Preterm Children

Bieleninik,

Kvestad,

Gold

et al. 2024

JAMA Netw Open

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ImportancePreterm children are at risk for neurodevelopment impairments.ObjectiveTo evaluate the effect of a music therapy (MT) intervention (parent-led, infant-directed singing) for premature children during the neonatal intensive care unit (NICU) stay and/or after hospital discharge on language development at 24 months’ corrected age (CA).Design, Setting, and ParticipantsThis predefined secondary analysis followed participants in the LongSTEP (Longitudinal Study of Music Therapy's Effectiveness for Premature Infants and Their Caregivers) randomized clinical trial, which was conducted from August 2018 to April 2022 in 8 NICUs across 5 countries (Argentina, Colombia, Israel, Norway, and Poland) and included clinic follow-up visits and extended interventions after hospital discharge.InterventionParticipants were children born preterm (&lt;35 weeks’ gestation) and their parents. Participants were randomized at enrollment to MT with standard care (SC) or SC alone; they were randomized to MT or SC again at discharge. The MT was parent-led, infant-directed singing tailored to infant responses and supported by a music therapist and was provided 3 times weekly in the NICU and/or in 7 sessions across 6 months after discharge. The SC consisted of early intervention methods of medical, nursing, and social services, without MT.Main Outcome and MeasuresPrimary outcome was language development, as measured by the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) language composite score, with the remaining BSID-III composite and subscale scores as the secondary outcomes. Group differences in treatment effects were assessed using linear mixed-effects models using all available data.ResultsOf 206 participants (103 female infants [50%]; mean [SD] GA, 30.5 [2.7] weeks), 51 were randomized to MT and 53 to SC at enrollment; at discharge, 52 were randomized to MT and 50 to SC. A total of 112 (54%) were retained at the 24 months’ CA follow-up. Most participants (79 [70%] to 93 [83%]) had BSID-III scores in the normal range (≥85). Mean differences for the language composite score were −2.36 (95% CI, −12.60 to 7.88; P = .65) for the MT at NICU with postdischarge SC group, 2.65 (95% CI, −7.94 to 13.23; P = .62) for the SC at NICU and postdischarge MT group, and −3.77 (95% CI, −13.97 to 6.43; P = .47) for the MT group at both NICU and postdischarge. There were no significant effects for cognitive or motor development.Conclusions and RelevanceThis secondary analysis did not confirm an effect of parent-led, infant-directed singing on neurodevelopment in preterm children at 24 months’ CA; wide CIs suggest, however, that potential effects cannot be excluded. Future research should determine the MT approaches, implementation time, and duration that are effective in targeting children at risk for neurodevelopmental impairments and introducing broader measurements for changes in brain development.Trial RegistrationClinicalTrials.gov Identifier: NCT03564184

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Preventive Intervention Program on the Outcomes of Very Preterm Infants and Caregivers: A Multicenter Randomized Controlled Trial

Cited by 12 publications

References 41 publications

Relationship between Maternal Touch, Maternal Self-Confidence, Infant Length, and Feeding Volume in High-Risk Infants: Touch on the Mind

Relationship between Maternal Touch, Maternal Self-Confidence, Infant Length, and Feeding Volume in High-Risk Infants: Touch on the Mind

Interventions to support parents, families and caregivers in caring for preterm or low birth weight infants at home: a systematic review

Music Therapy in Infancy and Neurodevelopmental Outcomes in Preterm Children

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