Influences of early intervention with new follow-up pattern on the neurodevelopment of preterm infants

Abstract

Objective To investigate the influence of early intervention with new follow-up pattern on the neurodevelopment of preterm infants. Methods From January 2014 to June 2015, a total of 408 preterm infants who were alive and discharged from department of Neonatology, Qinzhou Maternal and Child Health Care Hospital and regularly followed up at the outpatient service, were selected as research subjects. They were randomly divided into observation group (n=197) and control group (n=211) with the random digits table method. Infants in observation group were received a new follow-up pattern, including outpatient follow-up, onsite assessment and guidance, and telephone, WeChat or QQ, while infants in control group were received traditional follow-up pattern, including outpatient follow-up, and onsite assessment and guidance for the studies of neural development of infants. Physical growth monitoring and neurodevelopmental assessment were the main aspects of the follow-up. Early intervention mainly included infants nutrition management, feeding guidance, neuromuscular exercise training and social psychological support for family members, etc.. Neonatal behavioral neurological assessment (NBNA) score at 40 weeks of corrected age, and assessment results of Gesell Developmental Scale at 6 months and 12 months of corrected age were compared between two groups of infants by t test or chi-square test. This study was approved by the Medical Ethics Committee of Qinzhou Maternal and Child Heath Care Hospital and obtained the informed consents from infants′family members. Results ①There were no significant differences between two groups of infants at 40 weeks of corrected age in NBNA score abnormal rate and NBNA score value (P>0.05). ②Gesell Developmental Scale assessment results of infants at 6 months of corrected age showed as follows. The abnormal rates of 5 Gesell subscales including gross motor behavior, fine motor behavior, language behavior, adaptive behavior and personal social behavior of infants in observation group (11.7%, 10.2%, 4.1%, 8.6%, 6.6%) were all lower than those in control group (20.9%, 17.5%, 9.5%, 15.2%, 13.3%); the development quotient (DQ) values of 5 Gesell subscales of infants in observation group [(90.5±8.0), (90.8±8.6), (89.5±9.5), (90.0±9.6), (89.4±8.8)] were all higher than those in control group [(88.0±9.5), (88.2±8.3), (87.4±8.1), (87.9±9.1), (87.5±8.2)]; and all the differences above were statistically significant(χ2=6.253, 4.621, 4.678, 4.119, 5.016; t=2.686, 3.037, 2.375, 2.298, 2.240; all P<0.05). ③Gesell Developmental Scale assessment results of infants at 12 months of corrected age showed as follows. The abnormal rates of 5 Gesell subscales including gross motor behavior, fine motor behavior, language behavior, adaptive behavior and personal social behavior of infants in observation group (4.6%, 4.1%, 3.0%, 5.1%, 3.0%) were all lower than those in control group (10.4%, 10.0%, 8.5%, 10.4%, 8.5%); the DQ values of 5 Gesell subscales of infants in observation group [(91.3±6.8), (91.7±7.6), (89.5±9.4), (90.5±9.0), (91.3±7.7)] were all higher than those in control group [(89.5±7.9), (89.2±7.3), (87.5±8.0), (88.4±8.5), (89.0±7.1)]; and all the differences above were statistically significant (χ2=4.980, 5.356, 5.537, 4.035, 5.537; t=2.405, 3.459, 2.356, 2.432, 3.053; all P<0.05). Conclusion Early intervention with new follow-up pattern was more conduce to the early neurodevelopment of preterm infants. Key words: Early intervention (education); Neuropsychological tests; Neurobehavioral manifestations; Follow-up studies; Outcome assessment (health care); Gesell developmental scale; Infant, premature