Preemie Parenting Intervention

Preemie Parenting Intervention

Johnson S, Whitelaw A, Glazebrook C, et al. Randomized trial of a parenting intervention for very preterm infants: outcome at 2 years. J Pediatr(2009 Oct);155:488-94 Full Text | PDF

OBJECTIVES: To determine the efficacy of a neonatal parenting intervention for improving development in very preterm infants.

STUDY DESIGN: A cluster-randomized, controlled trial with a cross-over design and washout period was conducted in 6 neonatal centers. Two hundred thirty-three babies <32 weeks' gestation were recruited (intervention = 112; control = 121). Intervention families received weekly Parent Baby Interaction Programme (PBIP) sessions during neonatal intensive care unit admission and up to 6 weeks after discharge. Control families received standard care. All 195 infants remaining in the study at 24 months' corrected age were assessed by psychologists blinded to group allocation.

RESULTS: There was no significant difference in Mental Development Index (-0.9 points; 95% CI, -5.0, 3.2) or Psychomotor Development Index (2.5; -3.3, 8.4) scores between the intervention and control groups and no significant effect of intervention on Mental Development Index or Psychomotor Development Index scores for subgroups dichotomized by gestational age (<28 weeks/> or =28 weeks), parity (1st/other child) or mother's cohabiting status.

CONCLUSIONS: There was no effect of PBIP on infant development at 2 years' corrected age. Parenting interventions may be better delivered after discharge or targeted for preterm infants with high biological and social risk.

Comments. PBIP provides structured parental support during the neonatal period to facilitate attachment, enhance parent infant interaction, sensitize parents to their baby’s cues, facilitate parents’ confidence in identifying and meeting their baby’s needs, and to educate parents in developmental care principles. The authors found that gestational age was correlated negatively with number of sessions received in the NICU and positively with sessions received after discharge. Moreover, the PBIP was found not effective in improving cognitive or motor development in very preterm infants at 2 years’ corrected age. It is not a surprise because previous studies investigating the efficacy of parenting interventions for VLBW infants have generally produced variable and conflicting results. In this study, authors explained the ineffectiveness of this program by the fact that mean number of sessions provided by parents were less than the expected number of sessions that should be provided. This negative result should not discourage parents of LBW infants from doing PBIP sessions at home because contemporary studies that have reported positive effects on infant outcomes. SAA

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