Effectiveness of Family-Centered Intervention Program on Neurobehavioral and Neurophysiological Functions in Preterm Infants with Very Low Birth Weight
Date Issued
2016
Date
2016
Author(s)
Huang, Wan-Chi
Abstract
Background: Preterm infants with very low birth weight (VLBW) are at high risk of developmental disorders in their lifetime. Previous studies on family-centered care for preterm infants showed short- to medium-term neurobehavioral benefit. Few studies have explored the neurophysiological changes underlying effective in-hospital intervention in preterm infants, however differences existed in the patterns of spectral coherence as measured by using electroencephalography (EEG). Purposes: This study was aimed to examine the effects of a family-centered intervention program (FCIP) on the neurophysiological function and neurobehavioral performance in VLBW preterm infants in the first year compared to a usual care program (UCP), and to investigate the relationships between neurophysiological function and neurobehavioral outcome. Methods: VLBW preterm infants from three medical centers in Taiwan were recruited and were randomly allocated to the FCIP and UCP to receive interventions from hospitalization to 12 months of corrected age (CA). Infants were assessed neurophysiological function using the EEG in sleep and EEG/event-related potentials (ERPs) 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) at 6 and 12 months CA. Results: This study included 269 VLBW preterm infants (129 in the FCIP and 140 in the UCP). Cognitive, language, and motor composite scores at 6 and 12 months were comparable between groups. The FCIP showed greater increase in the EEG coherence in bilateral intra-hemispheric pairs in the frontal-to-parietal, temporal, and occipital regions from 1 to 4 months CA than the UCP (all p< significant level adjusted by false discovery rate). Among preterm infants with appropriate for gestational age, the peak latencies of P150 and N250 at F3 electrode in auditory oddball procedure were shorter in the FCIP group than in the UCP group (all p=0.01). The coherence pairs in prefrontal-to-temporal and parietal regions from 1 to 4 months were correlated with motor score at 12 months (β=4.0~12.3, all p <0.05); the peak latency of P150 was marginally correlated with cognitive score at 12 months (β=−0.04, p=0.1) in all preterm infants. Conclusions: The FCIP yielded changes in on the brain connectivity between 1 and 4 months CA but showed no obvious neurobehavioral effect at 6 and 12 months CA in VLBW preterm infants. Furthermore, certain electrophysiological measures were associated with subsequent motor and cognitive outcome in VLBW preterm infants.
Subjects
preterm infant
family-centered care
early intervention
intervention effect
neurophysiological function
SDGs
Type
thesis
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