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

22 de agosto de 2018 atualizado por: 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.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Real)

275

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

Não mais velho que 8 meses (Filho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Prevenção
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
Comportamental: Family-centered intervention program
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
Outros nomes:
  • FCIP
Outro: 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.
Comportamental: Usual care intervention program
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.
Outros nomes:
  • UCP

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Child: neurodevelopment functions (cognition, language and motor)
Prazo: 24 months of corrected age
Bayley Scales of Infant and Toddler Development - 2nd and 3rd edition
24 months of corrected age

Medidas de resultados secundários

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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

National Taiwan University Hospital

Colaboradores

National Health Research Institutes, Taiwan

Publicações e links úteis

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Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

22 de maio de 2012

Conclusão Primária (Real)

10 de janeiro de 2017

Conclusão do estudo (Real)

10 de janeiro de 2017

Datas de inscrição no estudo

Enviado pela primeira vez

29 de janeiro de 2013

Enviado pela primeira vez que atendeu aos critérios de CQ

6 de março de 2013

Primeira postagem (Estimativa)

8 de março de 2013

Atualizações de registro de estudo

Última Atualização Postada (Real)

24 de agosto de 2018

Última atualização enviada que atendeu aos critérios de controle de qualidade

22 de agosto de 2018

Última verificação

1 de março de 2017

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • 201103075RB

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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