Effectiveness of interventions on early neurodevelopment of preterm infants: a systematic review and meta-analysis

BMC Pediatrics

Marie-Hélène Proulx¹  Gwenaëlle De Clifford Faugère²  Andréane Lavallée²  Marilyn Aita³  Émilie Rioux⁴  Robyn Stremler⁵  Nancy Feeley⁶ 

[1] Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, H3C 3J7, Montréal, QC, Canada;Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, H3C 3J7, Montréal, QC, Canada;CHU Sainte-Justine Research Centre, 3175, chemin de la Côte-Sainte-Catherine, H3T 1C5, Montréal, QC, Canada;Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, H3C 3J7, Montréal, QC, Canada;CHU Sainte-Justine Research Centre, 3175, chemin de la Côte-Sainte-Catherine, H3T 1C5, Montréal, QC, Canada;Quebec Network on Nursing Intervention Research, PO Box 6128, Centre-ville, H3C 3J7, Montréal, QC, Canada;Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale centre-ville, H3C 3J7, Montréal, QC, Canada;Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, H3T 1E2, Montréal, QC, Canada;Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, M5T 1P8, Toronto, ON, Canada;Hospital for Sick Children (SickKids), 555 University Ave, M5G 1X8, Toronto, ON, Canada;Quebec Network on Nursing Intervention Research, PO Box 6128, Centre-ville, H3C 3J7, Montréal, QC, Canada;Ingram School of Nursing, McGill University, 680 Rue Sherbrooke Ouest #1800, H3A 2M7, Montréal, QC, Canada;Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, H3T 1E2, Montréal, QC, Canada;

关键词: Neurodevelopment;    Preterm infants;    Systematic review;    Interventions;    NICU;    Meta-analysis;   

DOI  :  10.1186/s12887-021-02559-6

来源: Springer

【 摘 要 】

BackgroundAs preterm infants’ neurodevelopment is shaped by NICU-related factors during their hospitalization, it is essential to evaluate which interventions are more beneficial for their neurodevelopment at this specific time. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of interventions initiated during NICU hospitalization on preterm infants’ early neurodevelopment during their hospitalization and up to two weeks corrected age (CA).MethodsThis systematic review referred to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines and was registered in PROSPERO (CRD42017047072). We searched CINAHL, MEDLINE, PubMed, EMBASE (OVID), Cochrane Systematic Reviews, CENTRAL, and Web of Science from 2002 to February 2020 and included randomized controlled/clinical trials conducted with preterm infants born between 24 and 366/7 weeks of gestation. All types of interventions instigated during NICU hospitalization were included. Two independent reviewers performed the study selection, data extraction, assessment of risks of bias and quality of evidence.ResultsFindings of 12 studies involving 901 preterm infants were synthesized. We combined three studies in a meta-analysis showing that compared to standard care, the NIDCAP intervention is effective in improving preterm infants’ neurobehavioral and neurological development at two weeks CA. We also combined two other studies in a meta-analysis indicating that parental participation did not significantly improve preterm infants’ neurobehavioral development during NICU hospitalization. For all other interventions (i.e., developmental care, sensory stimulation, music and physical therapy), the synthesis of results shows that compared to standard care or other types of comparators, the effectiveness was either controversial or partially effective.ConclusionsThe overall quality of evidence was rated low to very low. Future studies are needed to identify interventions that are the most effective in promoting preterm infants’ early neurodevelopment during NICU hospitalization or close to term age. Interventions should be appropriately designed to allow comparison with previous studies and a combination of different instruments could provide a more global assessment of preterm infants’ neurodevelopment and thus allow for comparisons across studies.Trial registrationProspero CRD42017047072.

【 授权许可】

CC BY