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A Family-Centered Intervention Program for Preterm Infants: Effects and Their Biosocial Pathways

22. august 2018 opdateret af: National Taiwan University Hospital

Four hypotheses will be tested in this study:

  1. The intervention group performs better in child, parent and transactions outcomes than the control group throughout the follow-up period.
  2. The intervention group shows greater changes in early neurophysiological brain functions and transactions within the family that lead to better neurodevelopmental outcomes than the control group.
  3. Certain polymorphisms of the dopamine-related genes are associated with the neurodevelopmental outcomes in VLBW preterm infants.
  4. Very low birth weight preterm infants carrying more genetic plasticity in the dopamine-related genes may benefit more from the interventions than those carrying less genetic plasticity.

Studieoversigt

Detaljeret beskrivelse

A total of 275 VLBW preterm infants (269 participants and 6 pilots) were recruited at three medical centers in northern and southern Taiwan and were randomly assigned to the FCIP or UCP group. Outcome assessments included primary (neurobehavioral development) and secondary measures (neurophysiological performance, parents' stress and transactions within the family). The neurophysiological and transactions data were examined for whether they mediate intervention effects on child development. In addition, these infants 219 VLBW preterm infants and 118 term infants in our prior intervention studies were collected buccal cells for assessment of the polymorphisms of dopamine-related genes, which are involved in the neurotransmission of cognitive, sensorimotor and behavioral-emotional systems and postulated to be associated with several developmental and psychiatric illnesses. The polymorphisms of dopamine-related genes were examined for potential moderating influence on the effects of the intervention for child development.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

275

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • Tainan, Taiwan, 704
        • National Cheng Kung University Hospital
      • Taipei, Taiwan, 100
        • National Taiwan University Hospital
      • Taipei, Taiwan, 104
        • Mackay Memorial Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

Ikke ældre end 8 måneder (Barn)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • birth body weight < 1500 grams
  • gestational age < 37 weeks
  • parents of Taiwan nationality, married or together at delivery, and northern family residing in greater Taipei and southern family residing in greater Tainan, Kaohsiung, or Chiayi

Exclusion Criteria:

  • severe neonatal and perinatal diseases (e.g., seizures, hydrocephalus, meningitis, grade III-IV IVH and grade II NEC)
  • congenital or chromosome abnormality
  • mother < 18 years, with mental retardation or history of maternal substance abuse at any time (smoking, alcohol, and drug)

Terminated Criteria:

  • diagnosis of brain injury (e.g., PVL, stage IV ROP or greater)
  • severe cardiopulmonary disease requiring invasive or non-invasive ventilator use at hospital discharge
  • hospital discharge beyond 44 weeks' post-menstrual age.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Family-centered intervention program
FCIP: family members were encouraged to present in all intervention sessions included 5 in-hospital intervention, 7 after-discharge interventions (0, 1, 2, 4, 6, 9, and 12 months of corrected age), and neonatal follow-up at 0, 1, 6, 12, 18, and 24 months of corrected age.
This program was in-hospital intervention, after-discharge intervention, and neonatal follow-up. Five sessions of in-hospital intervention emphasized in the parental involvements with modulation of the NICU, a teaching of child developmental skills, feeding support, massage, interactional activities, child developmental skills, parent support and education, and transition home preparation. The 7-session after-discharge intervention consisted of 4 clinic visits and 3 home visits with specific care in modulation of home environment, teaching of child developmental skills, feeding support, teaching of interactional activities, and parent support and education
Andre navne:
  • FCIP
Andet: Usual care intervention program
UCP: family members were invited to present at least one session of the 5 in-hospital intervention session. Parents and infants in the UCP group received 7 after-discharge phone calls (0, 1, 2, 4, 6, 9, and 12 months of corrected age) and neonatal follow-up at 0, 1, 6, 12, 18, and 24 months of corrected age.
This program was in-hospital intervention, after-discharge consultation, and neonatal follow-up. Five sessions of in-hospital intervention emphasized in the parental involvements with modulation of the NICU, a teaching of child developmental skills, feeding support, massage, interactional activities, child developmental skills, parent support and education, and transition home preparation. The after-discharge service was provided 7-phone calls for the general health consultation.
Andre navne:
  • UCP

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Child: neurodevelopment functions (cognition, language and motor)
Tidsramme: 24 months of corrected age
Bayley Scales of Infant and Toddler Development - 2nd and 3rd edition
24 months of corrected age

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change of neurodevelopment functions (motor) from baseline
Tidsramme: 0 months of corrected age
The Neonatal Neurobehavioral Examination-Chinese Version (NNE-C) 2. World Health Organization Quality of Life- Brief Taiwan version
0 months of corrected age
Child: neurodevelopment functions (behavior)
Tidsramme: 24 months of corrected age
Child behavior checklist version 1.5-5 Y 2. World Health Organization Quality of Life- Brief Taiwan version
24 months of corrected age
Change of neurodevelopment functions (cognition, language and motor) from baseline
Tidsramme: 6,12, and 24 months
Bayley Scales of Infant and Toddler Development - 3rd edition 2. World Health Organization Quality of Life- Brief Taiwan version
6,12, and 24 months
Parental functions and change from baseline (pressure)
Tidsramme: 0, 6, 12, 18, and 24 months of corrected age
Parenting Stress Index 2. World Health Organization Quality of Life- Brief Taiwan version
0, 6, 12, 18, and 24 months of corrected age
Parental functions and change from baseline (Quality of Life)
Tidsramme: 0, 6, 12, 18, and 24 months of corrected age
World Health Organization Quality of Life- Brief Taiwan version
0, 6, 12, 18, and 24 months of corrected age
Transactional functions and change from baseline
Tidsramme: 6, 12, and 18 months of corrected age
Mother-infant interaction in free play at 6, 12, and 18 months of corrected age
6, 12, and 18 months of corrected age
Transactional functions and change from baseline
Tidsramme: 6 and 12 months of corrected age
Wakeful Position Questionnaire at 6 and 12 months of corrected age
6 and 12 months of corrected age
Transactions function: affordance
Tidsramme: 18 months of corrected age
1. Affordances in the Home Environment Motor Development- Chinese version
18 months of corrected age
Child: Medical data
Tidsramme: Birth to 24 months of corrected age
Chart review
Birth to 24 months of corrected age
Child: growth data and change from baseline
Tidsramme: 0, 1, 4, 6, 12, 18, and 24 months of corrected age
Chart review and measurement
0, 1, 4, 6, 12, 18, and 24 months of corrected age
Child: neurophysiological functions and change from baseline
Tidsramme: 1 and 4 months of corrected age
Electroencephalogram/event-related potential
1 and 4 months of corrected age
Child: genotyping and gene expression
Tidsramme: 0 month of corrected age
Buccal cell collection
0 month of corrected age
Parental adherence to Intervention
Tidsramme: 32-36 weeks (5 sessions), 0, 1, 2, 4, 6, 9, and 12 months

Only assessed in FCIP group

  1. Parental motivation
  2. Goal attainment
  3. Home activity records
32-36 weeks (5 sessions), 0, 1, 2, 4, 6, 9, and 12 months

Samarbejdspartnere og efterforskere

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Publikationer og nyttige links

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Datoer for undersøgelser

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Studer store datoer

Studiestart (Faktiske)

22. maj 2012

Primær færdiggørelse (Faktiske)

10. januar 2017

Studieafslutning (Faktiske)

10. januar 2017

Datoer for studieregistrering

Først indsendt

29. januar 2013

Først indsendt, der opfyldte QC-kriterier

6. marts 2013

Først opslået (Skøn)

8. marts 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. august 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

22. august 2018

Sidst verificeret

1. marts 2017

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