Early Intervention Program Promotes Neurodevelopment And Physical Growth In Premature Infants And Reduces Parental Stress Of Their Parents

PARTⅠEARLY INTERVENTION PROGRAM PROMOTES NEURODEVELOPMENTS AND PHYSICAL GROWTH IN PREMATURE INFANTSObjective: Early intervention(EI)has been believed to improve the neurodevelopment of premature infants.However,its implementation in medical settings is time-consuming and resource-intensive,which limits its extensive use.In 2018,the Chinese Eugenics Association developed a homebased,post-discharge EI program.This study aims at evaluating the effect of this EI program on neurodevelopment and physical growth of premature infants through a prospective,partially blinded,randomized controlled trial,and a subsequent open phase.Methods: A total of 73 infants born at 28+ 0 ～ 31+ 6 weeks’ gestation who were admitted to the Children’s Hospital of Chongqing Medical University between July,2019,and June,2020,were enrolled.Another 33 infants were retrospectively recruited as the reference group.Thirty-seven infants randomized in the early intervention-standard care(EI-SC)group performed a 30-day EI during RCT period,while 36 infants allocated to SCEI 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.Results: During the RCT period(from T0 to T1),both groups had significant improvements in all outcome measures(all p < 0.001).A 30-day EI program was more effective in improving TIMP than standard care(from53.12 ± 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).EI-SC group had improvements in length(from 47.26±2.15 cm to 54.33±2.85 cm),weight(from 2.86±0.84 to 4.36±0.95 kg),and head circumference(from 32.06±1.33 to 35.98±1.86 cm),while SC-EI had improvements in length(from46.67±1.90 to 52.68±2.41cm),weight(2.73±0.75 to 3.95±0.79 kg),and head circumference(from 31.37±1.65 to 34.73±2.20 cm).EI-SC had much greater improvements than SC-EI group in all anthropometric measures(all p <0.05).From T0 to T2,there was no significant difference regarding the improvements in all measures between the groups(all p > 0.05).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).Conclusions: These findings demonstrated that a home-based,postdischarge EI program in this study was a practical approach to promote motor development and physical growth in early premature infants.PARTⅡ EARLY INTERVENTION PROGRAM REDUCES PARENTAL STRESS OF THE PARENTS OF PREMATURE INFNATSObjective: To evaluate the effect of a post-discharge family-involved early intervention program for early premature infants on reducing parental stress.Methods: The parents of early premature infants admitted to Children’s Hospital of Chongqing Medical University between July,2019 and June 2020 were randomly allocated into early intervention group(EI)group(37 families,follow-up lost three families),and standard care(SC)group(36 families,follow-up lost 5 families).Parents in the EI group provided standard post-discharge care and a 30-day early intervention program to the premature infants,while the parents in the SC group only provided standard care to their premature infants.Both cohorts of parents were assessed using a Parental Stress Index-Short Form(PSI-SF)before and two months after discharge.Repeated measures analysis was performed for comparison among groups.Results: Parents of early premature infants had high-level stress,with the mother’s PSI-SF being much higher than the father’s(94.91±7.72 vs.89.43±7.76,p<0.001).The PSI-SF of mothers and fathers in EI group were changed from 95.15±8.02 to 89.00±7.17,and from 82.00±5.64 to 0.74±7.14,respectively,while the PSI-SF of mothers and fathers in SC group were changed from 94.65±7.51 to 94.26±7.99,and 89.90±8.44 to 89.94±9.17,respectively.Parents in EI group had much greater PSI-SF decrement than in SC group(all p<0.05).In terms of the subdomain of PSI-SF,parents in EI group had greater decrement in parental distress than parents in SC group,whereas no difference were noted regarding to the change in parental child dysfunction interaction and difficult child between the groups(p>0.05).The delta change of PSI-SF was mainly related to the time spent on early intervention program and the postmenstrual age at discharge(p<0.001,and p=0.006,respectively).Conclusions: This home-based,post-discharge early intervention program could effectively reduce parental stress of the parents of premature infants,being worthy of large-scale implementation.