title: Cycled Light Exposure Reduces Fussing and Crying in Very Preterm Infants Timing for the Introduction of Cycled Light for Extremely Preterm Infants: A Randomized Controlled Trial The efficacy of massage on short and long term outcomes in preterm infants. No change in developmental outcome with incubator covers and nesting for very preterm infants in a randomised controlled trial Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. Effects of Early Intervention on Cognitive Function of Low Birth Weight Preterm Infants, Interpreting estimates of treatment effects: implications for managed care. Follow-up Outcomes at 1 and 2 Years of Infants Born Less Than 32 Weeks After Newborn Individualized Developmental Care and Assessment Program The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Effect of developmental care for very premature infants on neurodevelopmental outcome at 2 years of age. Developmental care does not alter sleep and development of premature infants. A Randomized Clinical Trial Evaluating Silicone Earplugs for Very Low Birth Weight Newborns in Intensive Care NIDCAP improves brain function and structure in preterm infants with severe intrauterine growth restriction Early experience alters brain function and structure. Improvement of Short- and Long-Term Outcomes for Very Low Birth Weight Infants: Edmonton NIDCAP Trial A randomized controlled trial of an early intervention program in low birth weight children: outcome at 2 years. Individualized developmental care for the very low-birth-weight preterm infant. Medical and neurofunctional effects. Nursery-based intervention with prematurely born babies and their mothers: are there effects? Early Intervention Improves Cognitive Outcomes for Preterm Infants: Randomized Controlled Trial Massage therapy improves neurodevelopment outcome at two years corrected age for very low birth weight infants. Is the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) effective for preterm infants with intrauterine growth restriction?
abstract: OBJECTIVE : To examine whether cycled lighting ( CL ) conditions during neonatal care in very preterm infants ( < 32 weeks ’ gestational age [ GA ] ) decrease crying and fussing behavior , improve the consolidation of sleep , and influence activity behavior at 5 and 11 weeks ’ postterm corrected age ( CA ) compared with preterm infants cared for in dim lighting ( DL ) conditions . METHODS : Thirty-seven preterm infants were r and omly assigned to  CL  ( 7 am–7 pm lights on , 7 pm–7 am lights off [ n = 17 ; mean GA : 30.6 ± 0.95 weeks ; 9 girls ] ) or DL ( lights off whenever the child is asleep [ n = 20 ; GA : 29.5 ± 2.1 weeks ; 8 girls ] ) conditions . Sleeping , crying , and activity behavior was recorded by using parental diaries and actigraphy at 5 and 11 weeks ’ CA . RESULTS : A significant reduction of fussing ( 59.4 minutes/24 hours [ ±25.8 minutes ] ) and crying ( 31.2 minutes/24 hours [ ±14.4 minutes ] ) behavior and a trend to higher motor activity during daytime was found in CL-exposed infants at 5 and 11 weeks ’ CA compared with infants cared for in DL conditions . No significant difference between groups was observed for sleep behavior at 5 and 11 weeks ’ CA . Infants in CL conditions showed a trend to improved daily weight gain ( average : 3.6 g/d ) during neonatal care compared with DL conditions . CONCLUSIONS : CL conditions in neonatal care have beneficial effects on infant ’s fussing and crying behavior and growth in the first weeks of life . This study supports the introduction of CL care in clinical neonatal practice Day-night cycled light improves health outcomes in preterm infants , yet the best time to institute cycled light is unclear . The hypothesis of this study was that extremely preterm infants receiving early cycled light  would have better health and developmental outcomes than infants receiving  late cycled light .  Infants born at ≤28 weeks gestation were r and omly assigned to early cycled light ( ECL ) starting at 28 weeks postmenstrual age [ PMA ] or late cycled light ( LCL ) , starting at 36 weeks PMA . Daylight was 200 - 600 lux and night was 5 - 30 lux . Primary outcomes were weight over time and length of hospitalization . Secondary outcomes were hospital costs , sleep development , and neurodevelopment at 9 , 18 , and 24 months corrected age . Of 121 infants r and omized , 118 were included in analysis . Weight gain in the two groups did not differ significantly but increased across time in both groups . In PMA weeks 36 - 44 , the mean weight gain was 193.8 grams in the ECL group compared to 176.3 grams in the LCL group . Effect sizes for weight were Cohen d = 0.26 and 0.36 for 36 and 44 weeks PMA . Infants in the ECL group went home an average of 5.5 days earlier than the LCL group , but this difference was not statistically significant . There were no group differences on neurodevelopmental outcomes . Although statistically non-significant , clinical ly important differences of improved weight gain and decreased hospital stay were observed with ECL . The small observed effect sizes on weight during hospitalization should be considered in future cycled light research with extremely preterm infants . © 2017 Wiley Periodicals , PURPOSE Premature infants lack the tactile stimulation they would have otherwise experienced in the womb . Infant massage is a developmentally supportive intervention that has been documented for several decades to have a positive effect on both full term and preterm infants . The purpose of this study was to assess the short and long term benefits of massage on stable preterm infants . METHODS A quasi experimental design was used , 66 infants were recruited from two university hospitals with tertiary level NICUs ; 32 infants received the massage therapy by their mothers . Data collection by a research er blind to the infants ' group assignments included weight at discharge , pain responses on the PIPP scale at discharge , length of stay in hospital , neuro-developmental outcome ( Bayley scores ) and breastfeeding duration at 12 months corrected age . RESULTS Infants who were massaged had significantly lower scores on the PIPP after a heel-stick compared to before the massage and had lower PIPP scores at discharge compared to the control group . Massaged infants had higher cognitive scores at 12 months corrected age . Weight gain , length of stay , breastfeeding duration and motor scores did not differ between groups . CONCLUSION Stable preterm infants benefit from massage therapy given by their mothers and may be a culturally acceptable form of intervention to improve the outcomes of preterm infants Objective : To investigate in a r and omised controlled trial the effect of basic elements of developmental care ( incubator covers and positioning aids ) on growth and neurodevelopment in infants born at < 32 weeks . Method : Infants were r and omised within 48 h of birth to a developmental care ( DC ) or st and ard care ( C ) group . Outcome measures at 1 and 2 years corrected age were growth , st and ardised neurological examinations , 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 for < 5 days or died within the first 5 days . In total , 179 infants met the inclusion criteria .  In-hospital mortality was 12/91 ( 13.2 % ) in the DC group and 8/88 ( 9.1 % ) in the C group . Assessment s were carried out on 147 children ( DC = 74 , C = 73 ) at 1 year and 142 children ( DC = 72 , C = 70 ) at 2 years . 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 of age in infants born at < 32 weeks . A positive effect on psychomotor development at 1 year did not continue at 2 years of age . Trial registration number : IS RCT N84995192 OBJECTIVE To evaluate associations between neonatal intensive care unit ( NICU ) room type ( open ward and private room ) and medical outcomes ; neurobehavior , electrophysiology , and brain structure at hospital discharge ; and developmental outcomes at 2 years of age . STUDY DESIGN In this prospect i ve longitudinal cohort study , we enrolled 136 preterm infants born < 30 weeks gestation from an urban , 75-bed level III NICU from 2007 - 2010 . Upon admission , each participant was assigned to a bedspace in an open ward or private room within the same hospital , based on space and staffing availability , where they remained for the duration of hospitalization . The primary outcome was developmental performance at 2 years of age ( n = 86 infants returned for testing , which was 83 % of survivors ) measured using the Bayley Scales of Infant and Toddler Development , 3rd Edition . Secondary outcomes were : ( 1 ) medical factors throughout the hospitalization ; ( 2 ) neurobehavior ; and ( 3 ) cerebral injury and maturation ( determined by magnetic resonance imaging and electroencephalography ) . RESULTS At term equivalent age , infants in private rooms were characterized by a diminution of normal hemispheric asymmetry and a trend toward having lower amplitude integrated electroencephalography cerebral maturation scores ( P = .02 ; β = -0.52 [ CI -0.95 , -0.10 ] ) . At age 2 years , infants from private rooms had lower language scores ( P = .006 ; β = -8.3 [ CI -14.2 , -2.4 ] ) and a trend toward lower motor scores ( P = .02 ; β = -6.3 [ CI -11.7 , -0.99 ] ) , which persisted after adjustment for potential confounders . CONCLUSION These findings raise concerns that highlight the need for further research into the potential adverse effects of different amounts of sensory exposure in the NICU environment The Infant Health and Development Program is a r and omized clinical trial to test the efficacy of educational and family support services and pediatric follow-up , offered during the first 3 years of life , in reducing the incidence of developmental delay in low birth weight preterm infants at eight clinical sites ( N = 985 ) . It was hypothesized that larger intervention effects would be found for the domains in which low birth weight preterm infants are known to have problems , specifically visual-motor and spatial skills and receptive language skills . These analyses explore the effects of the Infant Health and Development Program on different domains of cognitive functioning . Cognitive domains are identified by means of factor analysis of the intelligence tests used at 12 , 24 , and 36 months ( Bayley Scales of Infant Development ( including the Mental and Motor scales ) at 12 and 24 months ; the Stanford-Binet , Peabody Picture Vocabulary Test , and Beery Test of Visual Motor Intergration at 36 months ) . Our results reveal that , although intervention benefits accrue across cognitive domains at 24 and 36 months , gains are most pronounced for receptive language and visual-motor and spatial skills How should health care professionals choose among the many therapies cl aim ed to be efficacious for treating specific disorders ? The practice of evidence -based medicine provides an answer . Advocates of this approach urge health care professionals to base treatment choices on the best evidence from systematic research on both the efficacy and adverse effects of various therapeutic alternatives . Ideally , health care professionals would compare different treatments by referring to r and omized , double-blind , head-to-head trials that compared the treatment options . Although individual medications are typically well research ed when these placebo-controlled studies are performed , studies that directly compare treatments are rare . In the absence of direct head-to-head trials , other evidence comes from indirect comparisons of two or more therapies by examining individual studies involving each treatment . This article provides an introductory review of methods of such indirect comparisons of therapies across studies , provides examples of how these methods can be used to make treatment decisions , and presents a general overview of relevant issues and statistics for readers interested in underst and ing these methods more thoroughly OBJECTIVE . This was a r and omized , controlled trial to investigate the effect of Newborn Individualized Developmental Care and Assessment Program on growth , cognitive , psychomotor , and neuromotor development at 1 and 2 years in infants born at < 32 weeks ’ gestational age . METHODS . Infants were r and omly assigned within 48 hours of birth to the  newborn individualized developmental care and assessment program group ( intervention ) or basic developmental care group ( control group [ ie , incubator covers and nests ] ) . At 1 and 2 years ’ corrected age , growth was measured and st and ardized neurologic examinations were administered . Mental and psychomotor development was assessed by using the Dutch version of the Bayley Scales of Infant Development II . Neurologic outcome , Psychomotor Developmental Index , and Mental Developmental Index scores were combined a total outcome measure . RESULTS . One hundred sixty-eight infants were recruited ( intervention : 84 ; control : 84 ) . Four infants ( newborn intervention : 3 ; control : 1 ) were excluded because they were admitted less than or died within the first 5 days , leaving a total of 164 infants who met inclusion criteria .  In-hospital mortality was 8 of 81 in the intervention group and 3 of 83 in the control group . At 1 year of age 148 children ( intervention : 70 ; control : 78 ) and at 2 years of age 146 children ( intervention : 68 ; control : 78 ) were assessed . There was no significant difference in growth at 1 and 2 years of age . There was no significant difference found in neurologic outcomes or mental and psychomotor development at 1 and 2 years of age . When neurologic outcome , Mental Developmental Index and Psychomotor Developmental Index scores were combined , there still remained no significant difference . CONCLUSIONS . Newborn individualized developmental care and assessment program developmental care showed no effect on growth or neurologic , mental , or psychomotor development at 1 and 2 years of age in infants born at < 32 weeks . Duration of the intervention was not associated with neurologic and developmental outcome Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND To determine the effect of developmental care on neurodevelopmental outcome in formerly preterm infants at a corrected age of 2 years . METHODS A prospect i ve phase-lag study was performed at an Austrian neonatal intensive care unit ( NICU ) . From January 2003 to December 2005 ( study period of conventional care ) and January 2007 to December 2009 ( study period of developmental care ) , we enrolled all infants born in Tyrol at less than 32 weeks of gestation . During this period a total of 261 of 359 preterm infants ( participation rate 72.7 % ) completed the follow-up visit at 2 years of age ; there were 124 children in the conventional and 137 in the developmental care group . The association between developmental care and delayed motor or mental development ( Bayley Scales of Infant Development II ; psychomotor or mental developmental index < 85 ) was analyzed by means of logistic regression analysis at a corrected age of 24 months . RESULTS Children in the developmental care group showed less psychomotor delay than did those in the control group ( developmental care group : 16.1 % , conventional care group 27.4 % ; adjusted odds ratio 0.37 [ 95 % confidence interval : 0.19 - 0.74 ] , P=0.005 ) . Not smoking in pregnancy and higher gestational age were also significant predictors for a better psychomotor outcome at 2 years of age . Regarding cognitive outcome , no significant difference was observed between these two groups . CONCLUSION Our data implicate that developmental care may result in an improved 2-year psychomotor outcome in formerly preterm infants OBJECTIVE The Neonatal Individualized Developmental Care Program ( NIDCAP ) for very low birth weight ( VLBW ) preterm infants has been suggested by Als et al to improve several medical outcome variables such as time on ventilator , time to nipple feed , the duration of hospital stay , better behavioral performance on Assessment of Preterm Infants ' Behavior ( APIB ) , and improved neurodevelopmental outcomes . We have tested the hypothesis of whether the infants who had received NIDCAP would show advanced sleep-wake pattern , behavioral , and neurodevelopmental outcome . METHODS Thirty-five VLBW infants were r and omly assigned to receive NIDCAP  or routine infant care . The goals for NIDCAP intervention were to enhance comfort and stability and to reduce stress and agitation for the preterm infants by : a ) altering the environment by decreasing excess light and noise in the neonatal intensive care unit ( NICU ) and by using covers over the incubators and cribs ; b ) use of positioning aids such as boundary supports , nests , and buntings to promote a balance of flexion and extension postures ; c ) modification of direct h and s-on caregiving to maximize preparation of infants for , tolerance of , and facilitation of recovery from interventions ; d ) promotion of self-regulatory behaviors such as holding on , grasping , and sucking ; e ) attention to the readiness for and the ability to take oral feedings ; and f ) involving parents in the care of their infants as much as possible . The infants ' sleep was recorded at 36 weeks postconceptional age ( PCA ) and at 3 months corrected age ( CA ) using the Motility Monitoring System ( MMS ) , an automated , nonintrusive procedure for determining sleep state from movement and respiration patterns . Behavioral and developmental outcome was assessed by the Neurobehavioral Assessment of the Preterm Infant ( NAPI ) at 36 weeks PCA , the APIB at 42 weeks PCA , and by the Bayley Scales of Infant Development ( BSID ) at 4 , 12 , and 24 months CA . RESULTS Sleep developmental measures at 3 months CA showed a clear developmental change compared with 36 weeks PCA . These include : increased amount of quiet sleep , reduced active sleep and indeterminate sleep , decreased arousal , and transitions during sleep . Longest sleep period at night showed a clear developmental effect ( increased ) when comparing nighttime sleep pattern of infants at 3 months with those at 36 weeks of age . Day-night rhythm of sleep-wake increased significantly from 36 weeks PCA to 3 months CA . However , neither of these sleep developmental changes showed any significant effects of NIDCAP intervention . Although all APIB measures showed better organized behavior in NIDCAP patients , neither NAPI nor Bayley showed any developmental advantages for the intervention group . The neurodevelopmental outcome measured by the Bayley at 4 , 12 , and 24 months CA showed 64 % of the NIDCAP intervention group at the lowest possible score compared with 33 % of the control group . These findings could not be explained by the occurrence of intraventricular hemorrhage or the socioeconomic status of the parents , which showed no significant group effect . CONCLUSION The results of this study , including measures of sleep maturation and neurodevelopmental outcome up to 2 years of age did not demonstrate that the NIDCAP intervention results in increased maturity or development . Buehler et al ( Pediatrics . 1995;96:923 - 932 ) have reported that premature infants ( N = 12 ; mean gestational age 32 weeks , mean birth weight 1700 g ) who received developmental care compared with a similar group of infants who received routine care showed better organized behavioral performance on an APIB assessment at 42 weeks PCA . None of the medical outcome measures were significantly different in this study . Although our APIB results are in agreement , the results of the NAPI , the Bayley and sleep measures do not show an increase in neurodevelopmental maturation . In the earlier report by Als et al ( Journal of the American Medical Objective : To determine whether very low birth weight ( VLBW ) newborns ( < 1500 g ) wearing silicone earplugs grow larger and perform better on developmental exams than controls . Study Design : VLBW newborns ( n=34 ) were r and omized to wearing earplugs or not . Hospital outcomes were abstract ed from medical charts by research staff masked to intervention status . Fourteen extremely low birth weight ( ELBW ) newborns ( < 1000 g ) were also evaluated at 18 to 22 months . Result : After adjusting for birth weight , 11 surviving newborns in the earplug group were 225 g ( 95 % CI : 45 , 405 ) heavier at 34 weeks post menstrual age than the 13 controls . Six ELBW earplug infants scored 15.53 points ( 95 % CI : 3.03 , 28.02 ) higher than six controls on the Bayley Mental Development Index . Their head circumferences were 2.59 cm ( 95 % CI : 0.97 , 4.21 ) larger . Conclusion : Earplugs may facilitate weight gain in VLBW newborns . Better outcomes may persist at 18 to 22 months at least in ELBW infants Objective : The effect of NIDCAP ( Newborn Individualized Developmental Care and Assessment Program ) was examined on the neurobehavioral , electrophysiological and neurostructural development of preterm infants with severe intrauterine growth restriction ( IUGR ) . Study Design : A total of 30 infants , 27–33 weeks gestation , were r and omized to control ( C ; N=17 ) or NIDCAP/experimental ( E ; N=13 ) care . Baseline health and demographics were assessed at intake ; electroencephalography ( EEG ) and magnetic resonance imaging ( MRI )  at 35 and 42 weeks postmenstrual age ; and health , growth and neurobehavior at 42 weeks and 9 months corrected age ( 9 months ) . Results : C and E infants were comparable in health and demographics at baseline . At follow-up , E infants were healthier , showed significantly improved brain development and better neurobehavior . Neurobehavior , EEG and MRI discriminated between C and E infants . Neurobehavior at 42 weeks correlated with EEG and MRI at 42 weeks and neurobehavior at 9 months . Conclusion : NIDCAP significantly improved IUGR preterm infants ' neurobehavior , electrophysiology and brain structure . Longer-term outcome assessment and larger sample s are recommended OBJECTIVE To investigate the effects of early experience on brain function and structure . METHODS A r and omized clinical trial tested the neurodevelopmental effectiveness of the Newborn Individualized Developmental Care and Assessment Program ( NIDCAP ) .  Thirty preterm infants , 28 to 33 weeks ' gestational age ( GA ) at birth and free of known developmental risk factors , participated in the trial . NIDCAP was initiated within 72 hours of intensive care unit admission and continued to the age of 2 weeks , corrected for prematurity . Control ( 14 ) and experimental ( 16 ) infants were assessed at 2 weeks ' and 9 months ' corrected age on health status , growth , and neurobehavior , and at 2 weeks ' corrected age additionally on electroencephalogram spectral coherence , magnetic resonance diffusion tensor imaging , and measurements of transverse relaxation time . RESULTS The groups were medically and demographically comparable before as well as after the treatment . However , the experimental group showed significantly better neurobehavioral functioning , increased coherence between frontal and a broad spectrum of mainly occipital brain regions , and higher relative anisotropy in left internal capsule , with a trend for right internal capsule and frontal white matter . Transverse relaxation time showed no difference . Behavioral function was improved also at 9 months ' corrected age . The relationship among the 3 neurodevelopmental domains was significant . The results indicated consistently better function and more mature fiber structure for experimental infants compared with their controls . CONCLUSIONS This is the first in vivo evidence of enhanced brain function and structure due to the NIDCAP . The study demonstrates that quality of experience before term may influence brain development significantly OBJECTIVE : Our objective was to determine the impact of Newborn Individualized Developmental Care and Assessment Program (NIDCAP)-based care on length of stay of very low birth weight ( VLBW ) infants . Secondary outcome measures were days of ventilation , incidence of chronic lung disease , and 18-month neurodevelopmental outcomes . METHODS : This cluster-r and omized , controlled trial took place in a large NICU in Canada , with follow-up evaluation at 18 months of age , from September 1999 to September 2004 . One hundred VLBW singleton infants and 10 VLBW twin sets were assigned r and omly to NIDCAP-based or control care , and 90 % participated in follow-up assessment s. The intervention was NIDCAP-based care ( N = 56 ) , that is , care by NIDCAP-educated staff members and behavioral observations . The control group ( N = 55 ) received st and ard NICU care . Statistical analyses were adjusted for cluster r and omization . Although the intervention was not blinded , the pediatricians making the decisions to discharge the infants were not involved in the study , and the follow-up staff members were blinded with respect to group . RESULTS : NIDCAP group infants had reduced length of stay ( median : NIDCAP : 74 days ; control : 84 days ; P = .003 ) and incidence of chronic lung disease ( NIDCAP : 29 % ; control : 49 % ; odds ratio : 0.42 [ 95 % confidence interval : 0.18–0.95 ] ; P = .035 ) . At 18 months of adjusted age , NIDCAP group infants had less disability , specifically mental delay ( NIDCAP : 10 % ; control : 30 % ; odds ratio : 0.25 [ 95 % confidence interval : 0.08–0.82 ] ; P = .017 ) . CONCLUSION : NIDCAP-based care for VLBW infants improved short- and long-term outcomes significantly BACKGROUND Preterm infants are at increased risk of cognitive , motor and behavioral problems . Different intervention programs have been design ed in an attempt to improve outcome , but the results are conflicting . OBJECTIVE To examine the effects of an early intervention program on cognitive , motor and behavioral problems and parenting stress among low birth weight children at 2 years corrected age . METHODS A r and omized controlled trial was conducted including infants with a birth weight < 2000 g treated at the University Hospital of North Norway , to examine the effects of a  modified version of the Mother-Infant Transaction Program on cognitive , motor and behavioral outcomes and parenting stress . The children were assessed with the Bayley Scales of Infant Development and the Child Behavior Checklist/2 - 3 ( CBCL ) and the Parenting Stress Index were administered to the parents at 2 years corrected age . RESULTS Sixty-nine children in the intervention group and 67 in the control group were assessed at 2 years . There were no differences between the groups in cognitive or motor outcomes . The intervention group scored consistently lower on all CBCL syndrome scales , but no difference was significant . The mothers in the intervention group reported significantly lower parental stress in both child and parent domain , whereas the fathers reported lower stress in child domain compared to the control group . CONCLUSION This early intervention program does not improve cognitive , motor or behavioral outcomes at 2 years . There was a significant reduction in parenting stress reported by both mothers and fathers in the intervention group OBJECTIVE To investigate the effectiveness of individualized developmental care in reducing medical and neurodevelopmental sequelae for very low-birth-weight infants . DESIGN R and omized controlled trial . SETTING Newborn intensive care unit . PATIENTS Thirty-eight singleton preterm infants , free of known congenital abnormalities , weighing less than 1250 g , born before 30 weeks ' gestation , mechanically ventilated within 3 hours of delivery and for more than 24 hours in the first 48 hours , r and omly assigned to a control or an experimental group . INTERVENTION Caregiving by nurses specifically trained in individualized developmental care ; observation and documentation of the infants ' behavior within 12 hours of admission , and subsequently every 10th day ; developmental care recommendations and ongoing clinical support for the nurses and parents based on regular observation of the infant by developmental specialists ; and the availability of special caregiving accessories . MAIN OUTCOME MEASURES Medical outcome , including average daily weight gain ; number of days the infant required mechanical ventilation , oxygen , gavage tube feeding , and hospitalization ; severity of retinopathy of prematurity , bronchopulmonary dysplasia , pneumothorax , and intraventricular hemorrhage ; pediatric complications ; age at discharge ; and hospital charges . Neurodevelopmental outcome , including Assessment of Preterm Infants ' Behavior scale and quantified electroencephalography ( 2 weeks after due date ) ; and Bayley Scales of Infant Development and Kangaroo Box Paradigm ( 9 months after due date ) . RESULTS The infants in the experimental group had a significantly shorter duration of mechanical ventilation and supplemental oxygen support ; earlier oral feeding ; reduced incidence of intraventricular hemorrhage , pneumothorax , and severe bronchopulmonary dysplasia ; improved daily weight gain ; shorter hospital stays ; younger ages at hospital discharge ; and reduced hospital charges compared with the infants in the control group . At 2 weeks after their due date s , these infants also showed improved autonomic regulation , motor system functioning , self-regulatory abilities , and visual evoked potential measures ; and at 9 months , they had improved Bayley Mental and Psychomotor Developmental Index scores , as well as Kangaroo Box Paradigm scores . CONCLUSION Very low-birth-weight preterm infants may benefit from individualized developmental care in the neonatal intensive care unit in terms of medical and neurodevelopmental outcome The effects of nursery-based intervention with healthy , prematurely born babies and their socially disadvantaged mothers were evaluated . Mother-infant dyads were r and omly assigned to one of three intervention groups : In group one , the babies received special stimulation design ed to make them more active contributors to the interactions with their mothers ; in group two , mothers received special training to help them become more responsive to cues from their babies ; in group three , infants received stimulation and mothers received training . In addition , a fourth group of preterm babies who received regular hospital care served as a comparison group to assess the short-term effects of the stimulation program . Outcome measures design ed to evaluate various aspects of mother-infant interaction and infant development failed to reflect any effects of the interventions , either at the time the babies were discharged from the hospital or one year later . We attribute the lack of positive findings to the fact that the mothers faced numerous crises in their social environments . We conclude , therefore , that nothing short of massive social change is likely to result in measurable effects OBJECTIVE : The goal was to examine the effectiveness of an early intervention on cognitive and motor outcomes at corrected ages of 3 and 5 years for children with birth weights ( BWs ) of < 2000 g. METHODS : A r and omized controlled trial of a modified version of the Mother-Infant Transaction Program was performed . Outcomes were assessed with the Bayley Scales of Infant Development II and the Wechsler Preschool and Primary Scale of Intelligence-Revised at 3 and 5 years , respectively . McCarthy Scales of Children 's Abilities and the grooved pegboard test were used to test motor outcomes at 5 years . RESULTS : A total of 146 infants were assigned r and omly ( intervention group : 72 infants ; control group : 74 infants ) . The mean  BWs were 1396 ± 429 g for the intervention group and 1381 ± 436 g for the control group . After adjustment for maternal education , a nonsignificant difference in Mental Developmental Index scores at 3 years of 4.5 points ( 95 % confidence interval : −0.3 to 9.3 points ) in favor of the intervention group was found , whereas the intervention effect on full-scale IQ scores at 5 years was 6.4 points ( 95 % confidence interval : 0.6–12.2 points ) . Significantly more children in the intervention group had IQ scores of ≥85 at 3 and 5 years . There were no differences between the groups with respect to motor outcomes . CONCLUSION : This modified version of the Mother-Infant Transaction Program  improved cognitive outcomes at corrected age of 5 years for children with BWs of < 2000 BACKGROUND Long term effects of massage therapy in very preterm newborns infants are still to be described . Few studies evaluated neurodevelopment just at six months , and included late preterm infants . OBJECTIVE To study the effect of massage therapy on neurodevelopment of very low birth weight infants at two years corrected age . STUDY DESIGN Newborns with birth weight between > or= 750 and < or= 1500 g and gestational age < or= 32 weeks were r and omly assigned to massage therapy by mothers plus skin-to-skin care ( Intervention Group ) or just skin-to-skin care ( Control Group ) during their hospital stay . Growth and neurodevelopment outcome were evaluated at 2 years corrected age . RESULTS We followed 73 newborns ( 35 in Intervention Group , and 38 in Control Group ) . Both groups were similar in neonatal data .  Growth at 2 years corrected age was similar in both groups . Intervention Group had borderline higher Psychomotor Development Index and significantly higher Mental Development Index scores than Control Group . CONCLUSIONS We suggest that massage therapy by mothers combined to skin-to-skin care during neonatal hospital stay improves neurodevelopment outcome at 2 years corrected age 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 , r and omized to st and ard 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
target: Conclusion Current evidence suggests that developmental care in only NICU setting could have significant effect on mental and motor development of preterm infants , especially at 12 months of age .
background: Background The aim of this study was to review the effects of developmental care in neonatal intensive care unit ( NICU ) setting on mental and motor development of preterm infants .