Susan E Jacobs1, Jennifer Sokol, Arne Ohlsson. 1. Division of Neonatology, Department of Pediatrics, the Hospital for Sick Children and Mount Sinai Hospital, University of Toronto, Ontario, Canada.
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.
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.
Authors: Gloria B McAnulty; Frank H Duffy; Samantha C Butler; Jane H Bernstein; David Zurakowski; Heidelise Als Journal: Clin Pediatr (Phila) Date: 2009-05-15 Impact factor: 1.168