Early intervention after hospital discharge develops motor function in preterm infants: Study

The study is published in the BMC Pediatrics.

The implementation of early intervention (EI) in medical settings is time-consuming and resource-intensive, which limits its extensive use. Previously, the Chinese Eugenics Association developed a home-based, post-discharge EI program. However, its findings were inconclusive.

Therefore, Juan Fan and colleagues from the Department of Neonatology, National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China have conducted the present study to evaluate the impact of this EI program on neurodevelopment and physical growth of early preterm infants.

The authors carried out a prospective, partially blinded, randomized controlled trial (RCT), followed by an open phase. A total of 73 infants born at 28+ 0 ~ 31+ 6 weeks' gestation were enrolled. Another 33 infants were retrospectively recruited as the reference group.

Thirty-seven infants randomized in the first early intervention, then standard care (EI-SC) group performed a 30-day EI during RCT period, while 36 infants allocated to SC-EI group were given EI in the following open phase.

The test of infant motor performance (TIMP), development quotient (DQ), and anthropometric measures (length, weight, head circumference) were measured at the baseline (T0), termination of the RCT (T1), and termination of the open phase (T2). Repeated measures analysis was performed for comparison among groups.

The following key findings were observed-

a. From T0 to T1, both groups had significant improvements in all outcome measures (all p < 0.001).

b. A 30-day EI program was more effective in improving TIMP than standard care (from 53.12 ± 8.79 to 83.50 ± 11.85 in EI-SC group vs from 50.52 ± 8.64 to 75.97 ± 13.44 in SC-EI group, F = 4.232, p = 0.044).

c. EI-SC group also had greater improvements in length, weight, and head circumference than SC-EI group (all p < 0.05).

d. From T0 to T2, there was no significant difference regarding the improvements in all outcomes between the groups (all p > 0.05).

e. At the endpoint of T2, the EI-SC and SC-EI group had similar TIMP and anthropometric measures, but much higher than the reference group (all p < 0.05).

Hence, it was concluded that "a home-based, post-discharge EI program in this study was a practical approach to promote motor development and physical growth in early preterm infants."