Effect of Family-Centered Intervention Program on Neurobehavioral Outcome at 24 Months of Corrected Age and Its Relations with Early Neurophysiological Function in Preterm Infants

• Main Authors: Hsiao-Yuan Lee, 李筱媛
• Other Authors: Suh-Fang Jeng
• Format: Others
• Language: en_US
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/69c7wh

碩士 === 國立臺灣大學 === 物理治療學研究所 === 105 === Background and purpose: Preterm infants with very low birth weight (VLBW, birth weight < 1,500 g) are at risk of developmental disabilities. Previous studies showed favorable effect of family-centered intervention on neurobehavioral outcome in preterm infants in Western societies. However, the effect has rarely been elucidated in Eastern societies and the neural mechanism remains unclear. The purposes of this study were therefore to examine the effectiveness of a family-centered intervention program (FCIP) on developmental outcomes in VLBW preterm infants in Taiwan at 24 months of corrected age (CA) compared with a usual care program (UCP) and to assess if early neurophysiological changes mediated the 24-month neurobehavioral outcome. Methods: In a three-centered, randomized controlled trial, VLBW preterm infants were randomly assigned to the FCIP and UCP group for interventions from hospitalization to 12 months CA. Infants were assessed neurophysiological function using the electroencephalography in sleep and event-related potentials in an auditory oddball paradigm at 1 and 4 months CA, followed by neurobehavioral assessment using the Bayley Scales of Infant and Toddler Development- Third Edition (Bayley-III) and behavioral outcome by the Child Behavioral Check List for Ages 1.5-5 (CBCL/1.5-5) at 24 months CA. Clinical diagnosis and heath data were also collected. Results: The FCIP yielded beneficial effect on the gross motor development (p=0.02) and decreased the rate of developmental delay at 6 to 24 months CA (p=0.03) in VLBW preterm infants compared with the UCP. However, the FCIP showed no obvious effect on their cognitive, language and behavioral outcome. Among the significant early neurophysiological variables, only the mean amplitude of mismatch negativity in the left frontal region showed a tendency of mediating the intervention effect on gross motor outcome in preterm infants (p=0.06). Conclusions: Family-centered care favors the motor development and lowers the risk of developmental delay in Taiwanese VLBW preterm infants by 24 months CA than standard care. The identified early neurophysiological parameter provides some clues to the neurological mechanism for motor benefit.