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

22 août 2018 mis à jour par: 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.

Aperçu de l'étude

Description détaillée

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.

Type d'étude

Interventionnel

Inscription (Réel)

275

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

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

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

Pas plus vieux que 8 mois (Enfant)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

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.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: La prévention
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 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
Autres noms:
  • FCIP
Autre: 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.
Autres noms:
  • UCP

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Child: neurodevelopment functions (cognition, language and motor)
Délai: 24 months of corrected age
Bayley Scales of Infant and Toddler Development - 2nd and 3rd edition
24 months of corrected age

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change of neurodevelopment functions (motor) from baseline
Délai: 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)
Délai: 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
Délai: 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)
Délai: 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)
Délai: 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
Délai: 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
Délai: 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
Délai: 18 months of corrected age
1. Affordances in the Home Environment Motor Development- Chinese version
18 months of corrected age
Child: Medical data
Délai: Birth to 24 months of corrected age
Chart review
Birth to 24 months of corrected age
Child: growth data and change from baseline
Délai: 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
Délai: 1 and 4 months of corrected age
Electroencephalogram/event-related potential
1 and 4 months of corrected age
Child: genotyping and gene expression
Délai: 0 month of corrected age
Buccal cell collection
0 month of corrected age
Parental adherence to Intervention
Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

22 mai 2012

Achèvement primaire (Réel)

10 janvier 2017

Achèvement de l'étude (Réel)

10 janvier 2017

Dates d'inscription aux études

Première soumission

29 janvier 2013

Première soumission répondant aux critères de contrôle qualité

6 mars 2013

Première publication (Estimation)

8 mars 2013

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

24 août 2018

Dernière mise à jour soumise répondant aux critères de contrôle qualité

22 août 2018

Dernière vérification

1 mars 2017

Plus d'information

Termes liés à cette étude

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Informations sur les médicaments et les dispositifs, documents d'étude

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