| Title | Improvement of short- and long-term outcomes for very low birth weight infants: Edmonton NIDCAP trial. | | Author(s) | Peters KL, Rosychuk RJ, Hendson L, Coté JJ, McPherson C, Tyebkhan JM | | Institution | Faculty of Nursing, Perinatal Clinical Research Centre, University of Alberta, Edmonton, Canada. | | Source | Pediatrics 2009 Oct; 124(4):1009-20. | | MeSH | Age Factors
Alberta
Child Development
Cluster Analysis
Developmental Disabilities
Female
Follow-Up Studies
Gestational Age
Humans
Infant
Infant Care
Infant, Newborn
Infant, Premature, Diseases
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Kaplan-Meiers Estimate
Length of Stay
Male
Monitoring, Physiologic
Neonatal Nursing
Proportional Hazards Models
Risk Assessment
Sex Factors
Statistics, Nonparametric
Survival Rate
Time Factors
Treatment Outcome
United States
| | Abstract | 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-randomized, 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 randomly to NIDCAP-based or control care, and 90% participated in follow-up assessments. 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 standard NICU care. Statistical analyses were adjusted for cluster randomization. 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. | | Language | eng | | Pub Type(s) | Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
| | PubMed ID | 19786440 |
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