The newborn individualized developmental care and assessment program is not supported by meta-analyses of the data

Abstract

Objectives: To systematically review the effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) as compared with conventional care to improve long-term neurodevelopmental outcomes or short-term medical and neurodevelopmental outcomes in preterm and/or low birth weight infants. Study design: With the use of standard systematic review methodology, all randomized, controlled trials (RCTs) and prospective cohort studies evaluating in-hospital developmental care based on the framework of NIDCAP in preterm and/or low birth weight infants were identified. The quality of the RCTs was assessed. Meta-analyses were performed by using relative risk and risk difference for dichotomous data and weighted mean difference for continuous data with 95% confidence intervals. Results: Five RCTs (n = 136) and 3 phase-lag cohort studies (n = 185) met inclusion criteria. School-age neurodevelopmental outcomes after NIDCAP have not been reported. Meta-analyses of medical outcomes showed a statistically significant benefit of NIDCAP on requirement for supplemental oxygen. Neurodevelopmental outcome was improved at 9 or 12 months but not at 2 years. Conclusions: There is insufficient evidence to support the NIDCAP to improve medical and neurodevelopmental outcomes of preterm infants. (J Pediatr 2002;140:699-706)