Risk determinants in early intervention use during the first postnatal year in children born very preterm

BMC Pediatrics

Elaine Beller³  David Tudehope¹  Peter H Gray¹  David Cartwright⁴  Paul B Colditz²  Margo A Pritchard² 

[1] Mater Research Institute-University of Queensland, Mater Health Services, South Brisbane 4101, Australia;The University of Queensland Centre for Clinical Research, Herston 4029, Australia;Bond University, University Drive, Robina 4229, Australia;Department of Paediatrics and Child Health, The University of Queensland, Brisbane, Australia

关键词: Early intervention;    Preterm infant;    Neurodevelopment;   

Others  :  1144106
DOI  :  10.1186/1471-2431-13-201

 received in 2013-09-26, accepted in 2013-11-22,  发布年份 2013

【 摘 要 】

Background

Early interventions (EI) are recognised for their potential risk-reduction capacity. Although developmental delay is common in children born very preterm reports continue to suggest poor uptake of EI services. This study examined the risk determinants of EI in Australian children born less than 32 weeks gestation during the first year of life.

Methods

As part of a multi-centre-randomised-trial, 195 children were prospectively studied during their first year of life and EI use, type of follow-up, perinatal, social and parental psychosocial risk factors were collected using questionnaires. Child neurodevelopmental disability-status was assessed at 12-months (cerebral palsy, blind, deaf, developmental quotient 1standard deviation (SD) below mean). The associations between EI and variables were examined using Pearson’s chi-squared test (χ²) and regression techniques.

Results

A total of 55% of children received EI, 51% attended post discharge neonatal intensive care unit (NICU) and the remainder attended exclusive primary health care. Risk factors included, 50% perinatal, 19% social and 34% psychosocial and at 12-months 23% were categorised as disabled. Low social risk and NICU follow-up attendance were significantly associated with EI use but only perinatal risk (OR 3.1, 95% CI 1.7, 5.6, p = <0.01) and disability (OR 2.2, 95% CI 1.1, 4.7, p = 0.04) independently predicted EI use.

Conclusions

It is reassuring that children with perinatal risk receive EI, opportunity remains to improve EI uptake in families with social and parental psychosocial risk during the first year of life.

【 授权许可】

   
2013 Pritchard et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Hack M: Survival and neurodevelopmental outcomes of preterm infants. J Pediatr Gastroenterol Nutr 2009, 48(1):121-122.
• [2]Hack M, Carter L, Schluchter M, Klein N, Forrest CB: Self-perceived health, functioning and well-being of very low birth weight infants at age 20 years. J Pediatr Gastroenterol Nutr 2007, 151(6):635-641.
• [3]Hille ET, Weisglas-Kuperus N, Van Goudoever JB, Jacobusse GW, Ens-Dokkum MH, De Groot L, Wit JM, Geven WB, Kok JH, De Kleine MJ, et al.: Functional outcomes and participation in young adulthood for very preterm and very low birth weight infants: the Dutch project on preterm and small for gestational age infants at 19 years of age. Pediatrics 2007, 120(3):587-595.
• [4]Schmidt B: Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months: results from the trial of indomethacin prophylaxis in preterms. JAMA 2003, 289(9):1124-1129.
• [5]O’Shea TM, Allred EN, Dammann O, Hirtz ED, Kuban KCK, Paneth N, Leviton A: The ELGAN study of the brain and related disorders in extremely low gestational age newborns. Early Hum Dev 2009, 85(11):719-725.
• [6]Hwang AW, Soong WT, Liao HF: Influences of biological risk at birth and temperament on development at toddler and preschool ages. Child Health Care Dev 2009, 35(6):817-825.
• [7]Hillemeier MM, Farkas G, Morgan PL, Martin MA, Maczuga SA: Disparities in the prevalence of cognitive delay: how early do they appear? Paediatr Perinat Epidemiol 2009, 23(3):186-198.
• [8]Melnyk BM, Feinstein N, Fairbanks E: Two decades of evidence to support implementation of the COPE program as standard practice with parents of young unexpectedly hospitalized/critically ill children and premature infants. Paediatr Nurs 2006, 32(5):475-481.
• [9]Brown GT, Burns SA: The efficacy of neurodevelopmental treatments in paediatrics: a systematic review. Br J Occup Ther 2006, 64:235-244.
• [10]Spittle A, Orton J, Doyle LW, Boyd R: Early developmental intervention programs post hospital discharge to prevent motor and cognitive impairments in preterm infants. Cochrane Database Syst Rev 2007, 18(2):CD005495.
• [11]Organisation for Economic Co-operation and Development., & Source OECD (Online service): Starting strong II: Early childhood education and care. Paris: OECD; 2006.
• [12]Irwin L, Siddiqi A, Hertzman C: Early child development: a powerful equalizer: final report. Geneva: World Health Organisation’s Commission on the Social Determinants of Health; 2007.
• [13]Sanders MR: Triple P-positive parenting program: towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clin Child Fam Psychol Rev 1999, 2(2):71-90.
• [14]Dawe S, Harnett PH: Parents Under Pressure Program. Counselor: The Magazine for Addiction Professionals. 2008 April:22-29.
• [15]Homel R, Freiberg K, Lamb C, Leeck M, Carr A: The Pathways to Prevention Project: The first five years. Sydney: Mission Australia and the Key Centre for Ethics, Law, Justice & Governance, Griffith University; 2006.
• [16]Wang CJ, McGlynn EA, Brook RH, Leonard CH, Piecuch RE, Hsueh SI, Schuster MA: Quality-of-care indicators for the neurodevelopmental follow-up of very low birth weight children: results of an expert panel process. Pediatrics 2006, 117:2080-2092.
• [17]Committe on Fetus and Newborn: Hospital discharge of the high-risk neonate. Pediatrics 2008, 122(5):1119-1126.
• [18]Pritchard M, Colditz P, Tudehope D, Gray P, Cartwright D, Wigg N, Beller E: Measuring sensorineural disability in preterm children using a public health screening strategy: a randomised controlled trial. J Paediatr Child Health 2008, 44(7):424.
• [19]Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 1987, 150:782-786.
• [20]Abidin RR, Wilfong E: Parenting stress and its relationship to child health care. Child Health Care 1989, 18(2):114-116.
• [21]Griffiths R: The Griffiths mental developmental scale (birth to 2 years): the 1996 revision. Oxon: The Test Agency; 1996.
• [22]Bayley N: Bayley Scales of Infant Development. 2nd edition. San Antonio: The Psychological Corporation; 1993.
• [23]Kirby R, Swanson M, Kelleher KJ, Bradley RH, Casey PH: Identifying at-risk children for early intervention services: lessons from the infant health and development program. J Pediatrics 1993, 122(5 Pt 1):680-686.
• [24]Roberts G, Howard K, Spittle A, Brown NC, Anderson PJ, Doyle LD: Rates of early intervention services in very preterm children with developmental disabilities at age 2 years. J Paedictrics Child Health 2008, 44:276-280.
• [25]Tin W, Fritz S, Wariyar U, Hey E: Outcomes of very preterm birth: children reviewed with ease at 2 years differed from those followed with difficulty. Arch Dis Child Fetal Neonatal Ed 1998, 79:F83-F87.
• [26]Callanan C, Doyle LW, Rickards AL, Kelly EA, Ford GW, Davis NM: Children followed with difficulty: how do they differ? J Paedictrics Child Health 2001, 37:152-156.
• [27]Pritchard MA, Colditz PB, Beller EM: Parental experiences and preferences which influence subsequent use of post-discharge health services for children born very preterm. J Paediatr Child Health 2007, 44(5):281-284.
• [28]Bello A, Quartey J, Appiah L: Screening for developmental delay among children attending a rural community welfare clinic in Ghana. BMC Pediatr 2013., 13(119)