Family integrated care: very preterm neurodevelopmental outcomes at 18 months

医学 新生儿重症监护室 贝利婴儿发育量表 胎龄 混淆 儿科 入射(几何) 逻辑回归 优势比 队列 队列研究 认知 怀孕 内科学 精神运动学习 物理 光学 精神科 生物 遗传学
作者
Anne Synnes,Julie Petrie,Ruth E. Grunau,Paige Church,Edmond Kelly,Diane Moddemann,Xiang Y. Ye,Shoo K. Lee,Karel O’Brien
出处
期刊:Archives of Disease in Childhood-fetal and Neonatal Edition [BMJ]
卷期号:107 (1): 76-81 被引量:31
标识
DOI:10.1136/archdischild-2020-321055
摘要

To examine whether the family integrated care (FICare) programme, a multifaceted approach which enables parents to be engaged as primary caregivers in the neonatal intensive care unit, impacts infant neurodevelopment and growth at 18 months' corrected age.Prospective cohort study of infants born <29 weeks' gestational age (GA) who participated in the FICare cluster randomised control trial (cRCT) and were assessed in the Canadian Neonatal Follow-Up Network (CNFUN). The primary outcome measure, Cognitive or Language composite score <85 on the Bayley-III, was compared between FICare exposed and routine care children using logistic regression, adjusted for potential confounders and employing generalised estimation equations to account for clustering of infants within sites.Of 756 infants <29 weeks' GA in the FICare cRCT, 505 were enrolled in CNFUN and 455 were assessed (238 FICare, 217 control). Compared with controls, FICare infants had significantly higher incidence of intraventricular haemorrhage (IVH) (19.5% vs 11.7%, p=0.024) and higher proportion of employed mothers (76.6% vs 73.6%, p=0.043). There was no significant difference in the odds of the primary outcome (adjusted OR: 0.92 (0.59 to 1.42) FiCare vs Control) on multivariable analyses adjusted for GA, IVH and maternal employment. However, Bayley-III Motor scores (adjusted difference in mean (95% CI) 3.87 (1.22 to 6.53) and body mass index 0.67 (0.36 to 0.99) were higher in the FICare group.Very preterm infants exposed to FICare had no significant difference in incidence of cognitive or language delay but had better motor development.Participants in this cohort study were previously enrolled in a registered trial: NCT01852695.
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