Early intervention impact on neurodevelopmental outcome of very preterm infants and VLBW infants at 1 year corrected age

Abstract

Objective To evaluate neurodevelopmental outcome of very preterm( gestational age < 32 weeks) and very low birth weight infant (VLBWI) (weight< 1 500 g) and to examine the effectiveness of an early intervention program till 12 months corrected age. Methods Seventy followed-up very preterms and VLBWI in Jinan Maternity and Childcare Hospital were enrolled in this study from January 2012 to and were divided into two groups by birth weight.All infants received 20 items of behavioral neurological assessment at 1 to 12 months corrected age and tested mental and psychomotor development with the use of CDCC at 6, 12 months corrected age.The preterms who were abnomal in the 20 items of behavioral neurological assessment would receive early intervention (including kinesitherapy, physiotherapy, cereal circulation therapeutic equipment) by physiotherapists and their parents who received an intervention program training and were strongly encouraged to participate in the intervention sessions.The intervention method was adjusted according to the neurological assessment.The SPSS statistical software package for Windows, version 15.0, was used to run Fisher's exact test and t-test on the data presented, and P value of less than 0.05 was regarded as statistically significant. Results The average gestational age of infants was (30.4±1.8) weeks, and average birth weight (1 463.7±307.5)g.The incidence of extrauterine growth restriction was 57.1% at first follow-up.The incidence of neurodevelpmental impairment NDI) and cerebral palsy tendency at 6 corrected months were 14.3%, 8.6% respectively.At 12 months corrected age, the incidence of NDI decreased to 2.9% and cerebral palsy to 2.9%.There was significant difference in the incidence of NDI between 6 and 12 corrected months.There was no significant difference in the incidence of psychomotor developmental index <70, mental developmental index<70, NDI and cerebral palsy between the two groups. Conclusion The early intervention program can improve VLBWI neurodevelopmental outcomes at 12 months' corrected age and reduce the incidence of cerebral palsy. Key words: Very low gestational age infant; Very low birth weight infant; CDCC; Neurodevelopmental impairment; Cerebral palsy; Early intervention