【論文摘要】Effects of Early Intervention for Preterm Infants: Outcomes of Motor Function, Lung Function and Health-Related Quality of Life during School Age

Abstract

Background and Purpose: Infants born preterm are at risk for neurodevelopmental disorders and adverse long-term health outcomes. Previous studies have shown short-term and mid-term effects of early intervention for preterm children. However, very limited research has investigated the long-term effects. Our research team previously conducted a randomized control trial to examine the effects of two comprehensive early intervention programs: clinicalbased intervention program (CBIP) and home-based intervention program (HBIP) compared to usual care program (UCP) on very low birth weight (VLBW) preterm infants. The purpose of the present study was to examine the long-term effects of these early interventions programs on preterm children’s motor function, lung function and health-related quality of life (HRQoL) during school age. Methods: Thirty-nine preterm children (10 UCP, 14 CBIP, 15 HBIP) and 13 full-term children who participated in our previous intervention study were recruited at 10-11 years of age. Children’s motor function was examined using Bruininks-Oseretsky Test of Motor Proficiency, Second Edition. Lung function was measured by pulmonary function test with a computerized spirometer. HRQoL was measured by parental reports of Pediatric Quality of Life Inventory. One-way analysis of variance and Kruskal-Wallis test were conducted for normally distributed and non-normally distributed outcomes, respectively, to investigate the differences among 4 groups of children. Results: Compared to full-term peers, preterm children in the UCP group demonstrated significantly poorer motor function, indicated by lower scores of upper limb coordination (p = 0.002), body coordination (p = 0.04) and total motor composite (p = 0.04). They also showed lower forced expiratory volume (p = 0.008) and lower forced vital capacity (p = 0.04). While preterm children in the HBIP group showed comparable outcomes with term children, children in the CBIP group had significantly poorer performance in upper limb coordination (p = 0.002) than full-term peers did. All children were reported to have comparable HRQoL. Conclusion: Our study shows positive effects of early intervention on motor function and lung function of preterm children during school age. Furthermore, home-based early intervention appears to be more beneficial than clinical-based program for the long-term outcomes of preterm children. Clinical Relevance: Early intervention programs for preterm infants should be provided with comprehensive child-, parent-, and dyad-focused services to enhance long-term outcomes.