Journal Article

Family integrated care: very preterm neurodevelopmental outcomes at 18 months

Banihani, Rudaina, Adie, Mohammad, Petrie, Julie, Lee, Shoo K, Piedboeuf, Bruno, Synnes, Anne, Silva, Orlando Da, Pillay, Thevanisha, Synnes, Anne R, Mehrem, Ayman Abou, Church, Paige, Shah, Prakesh S, Ye, Xiang, Zwicker, Jill, Kanungo, Jaideep, Coughlin, Kevin, O'Brien, Karel, Drolet, Christine, Cabo, Cecilia de, Bélanger, Sylvie, Moddemann, Diane, Hendson, Leonora, Ng, Eugene, Nwaesei, Chukwuma, Grunau, Ruth E, Ting, Joseph, Afifi, Jehier, Alvaro, Ruben, Luu, Thuy Mai, Kelly, Edmond, Grunau, Ruth

2022

Overview

ObjectiveTo examine whether the family integrated care (FICare) programme, a multifaceted approach which enables parents to be engaged as primary caregivers in the neonatal intensive care unit, impacts infant neurodevelopment and growth at 18 months’ corrected age.Design/MethodsProspective cohort study of infants born <29 weeks’ gestational age (GA) who participated in the FICare cluster randomised control trial (cRCT) and were assessed in the Canadian Neonatal Follow-Up Network (CNFUN). The primary outcome measure, Cognitive or Language composite score <85 on the Bayley-III, was compared between FICare exposed and routine care children using logistic regression, adjusted for potential confounders and employing generalised estimation equations to account for clustering of infants within sites.ResultsOf 756 infants <29 weeks’ GA in the FICare cRCT, 505 were enrolled in CNFUN and 455 were assessed (238 FICare, 217 control). Compared with controls, FICare infants had significantly higher incidence of intraventricular haemorrhage (IVH) (19.5% vs 11.7%, p=0.024) and higher proportion of employed mothers (76.6% vs 73.6%, p=0.043). There was no significant difference in the odds of the primary outcome (adjusted OR: 0.92 (0.59 to 1.42) FiCare vs Control) on multivariable analyses adjusted for GA, IVH and maternal employment. However, Bayley-III Motor scores (adjusted difference in mean (95% CI) 3.87 (1.22 to 6.53) and body mass index 0.67 (0.36 to 0.99) were higher in the FICare group.ConclusionsVery preterm infants exposed to FICare had no significant difference in incidence of cognitive or language delay but had better motor development.Trial registration numberParticipants in this cohort study were previously enrolled in a registered trial: NCT01852695

• Publisher: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health,BMJ Publishing Group LTD
• Subject: Babies / Body mass index / Breast Feeding / Breastfeeding & lactation / Canada / Caregivers / Cerebral palsy / Child Development / Children & youth / Cochlear implants / Cognitive Dysfunction - diagnosis / Data collection / Developmental Disabilities - diagnosis / Families & family life / Female / Follow-Up Studies / Gestational age / health services research / Hearing aids / Hearing loss / Humans / Infant / Infant, Extremely Premature / Infant, Newborn / Infants / Integrated delivery systems / Intensive care / Intensive Care Units, Neonatal / Intensive Care, Neonatal - organization & administration / Intervention / Language / Language Development Disorders - diagnosis / Multiple births / Neonatal care / neonatology / Newborn babies / Nosocomial infections / Original research / Parent-Child Relations / Parents & parenting / Parents - psychology / Patient Care Team / Pediatrics / Premature babies / Premature birth / Prospective Studies / Stress, Psychological - prevention & control / Traumatic brain injury / Visual impairment / Weight Gain