Elsevier

The Journal of Pediatrics

Volume 154, Issue 1, January 2009, Pages 33-38.e2
The Journal of Pediatrics

Original article
The Infant Behavioral Assessment and Intervention Program for Very Low Birth Weight Infants at 6 Months Corrected Age

https://doi.org/10.1016/j.jpeds.2008.07.039Get rights and content

Objective

To determine whether the Infant Behavioral Assessment and Intervention Program (IBAIP), designed to support and enhance infants' self-regulatory competence, improved developmental and neurobehavioral outcomes in very low birth weight (VLBW) infants.

Study design

We randomized 86 infants to 1 intervention before discharge and to 6 to 8 home interventions until 6 months corrected age, and 90 control infants received standard care. Developmental and behavioral outcomes were evaluated at 6 months corrected age with the Bayley Scales of Infant Development-II (BSID-II). Neurobehavioral functioning was evaluated with the Infant Behavioral Assessment (IBA) at baseline and at 6 months corrected age.

Results

Despite randomization, some differences in neonatal characteristics were found between the intervention and control infants. After adjustment, intervention effects of 7.2 points (± standard error 3.1) on the Mental Developmental Index and 6.4 ± 2.4 points on the Psychomotor Developmental Index favored the intervention infants. The Behavioral Rating Scale of the BSID-II (P = .000) and the IBA (more approach [P = .003] and less stress [P = .001] over time) also favored the intervention infants.

Conclusions

The IBAIP improved the mental, motor, and behavioral outcomes of VLBW infants at 6 months corrected age.

Section snippets

Methods

A randomized controlled trial was carried out in Amsterdam, the Netherlands. Two level-III hospitals with neonatal intensive care unit facilities and all 5 city hospitals participated. The Medical Ethics Committees of all hospitals involved approved the study design. All infants of gestational age (GA) < 32 weeks and/or birth weight <1500 g whose parents lived in Amsterdam were eligible for the study. Infants with severe congenital abnormalities, those born of mothers with a documented history

Results

Recruitment took place between January 2004 and April 2006. A total of 315 infants were eligible for the study (Figure). Ultimately 176 infants and their parents participated; 86 were assigned to the intervention group, and 90 were assigned to the control group. NIDCAP formed no standard part of the care, although a limited number of very ill infants received NIDCAP care, equally divided between the intervention (n = 4) and control groups (n = 4). All except 1 of the 86 intervention infants

Discussion

Our data show that the IBAIP improved developmental and neurobehavioral outcomes in our VLBW infants at age 6 months. Because of greater immaturity and illness, adjustments for baseline differences were warranted and revealed better mental and motor development in the infants in the intervention group. Consistent with the aim of the intervention, the intervention group also had more positive behavioral and neurobehavioral outcomes. This was demonstrated on the BRS by greater information

References (30)

  • B. Fallang et al.

    Quality of reaching and postural control in young preterm infants is related to neuromotor outcome at 6 years

    Pediatr Res

    (2005)
  • E. van de Weijer-Bergsma et al.

    Attention development in infants and preschool children born preterm: a review. Infant Behav Dev [serial online]

  • The Science of Early Childhood Development: Closing the Gap Between What We Know and What We Do

  • Perspectives: Early Influences on Brain Architecture

  • M. Bronson

    Control systems in the brain

  • Cited by (78)

    • Protecting the brain of the micropreemie

      2022, Seminars in Fetal and Neonatal Medicine
    View all citing articles on Scopus

    Supported by grants from the Innovatiefonds Zorgverzekeraars (project 576, supporting the implementation of the intervention program) and Zorg Onderzoek Nederland (project 62200032, supporting the first author, who wrote the first draft of the manuscript). The sponsors had no involvement in study design; collection, analysis, or interpretation of the data; writing of the report; or the decision to submit the manuscript for publication. The authors declare no conflicts of interest.

    The trial is registered with controlled-trials.com (ISRCTN65503576).

    View full text