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. 2012;1(4):184-194.
doi: 10.4103/2249-4847.105982.

School Age Effects of the Newborn Individualized Developmental Care and Assessment Program for Medically Low-Risk Preterm Infants: Preliminary Findings

Gloria McAnulty  1 , Frank H Duffy, Sandra Kosta, Neil I Weisenfeld, Simon K Warfield, Samantha C Butler, Jane Holmes Bernstein, David Zurakowski, Heidelise Als
Affiliations

School Age Effects of the Newborn Individualized Developmental Care and Assessment Program for Medically Low-Risk Preterm Infants: Preliminary Findings

Gloria McAnulty et al. J Clin Neonatol. 2012.

Abstract

Background: By school age, even low risk moderately preterm-born children show more neuro-cognitive deficits, underachievement, behavioral problems, and poor social adaptation than full-term peers.

Aim: To evaluate the outcomes at school-age for moderately preterm-born children (29-33 weeks gestational age), appropriate in growth for gestational age (AGA) and medically at low-risk, randomized to Newborn Individualized Developmental Care and Assessment Program (NIDCAP) or standard care in the Newborn Intensive Care Unit. At school-age, the experimental (E) group will show better neuropsychological and neuro-electrophysiological function, as well as improved brain structure than the control (C) group.

Materials and methods: The original sample consisted of 30 moderately preterm-born infants (29 to 33 weeks), 23 (8C and 15E) of them were evaluated at 8 years of age, corrected-for-prematurity with neuropsychological, EEG spectral coherence, and diffusion tensor magnetic resonance imaging (DT MRI) measures.

Results: E-performed significantly better than C-group children on the Kaufman Assessment Battery for Children-Second Edition (KABC-II) and trended towards better scores on the Rey-Osterrieth Complex Figure Test. They also showed more mature frontal and parietal brain connectivities, and more mature fiber tracts involving the internal capsule and the cingulum. Neurobehavioral results in the newborn period successfully predicted neuropsychological functioning at 8 years corrected age.

Conclusion: Moderately preterm infants cared for with the NIDCAP intervention showed improved neuropsychological and neuro-electrophysiological function as well as improved brain structure at school-age.

Keywords: Diffusion tensor magnetic resonance imaging; electroencephalogram; neuropsychological function; newborn individualized developmental care and assessment program; prematurity; school-age; spectral coherence.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Consort chart
Figure 2
Figure 2
Standard EEG electrode names and positions. Head in vertex view, nose above, left ear to left. EEG electrodes: Z: Midline: FZ: Midline Frontal; CZ: Midline Central; PZ: Midline parietal; OZ: Midline occipital. Even numbers, right hemisphere locations; odd numbers, left hemisphere locations: Fp: Frontopolar; F: Frontal; C: Central; T: Temporal; P: Parietal; O: Occipital. The standard 19, 10-20 electrodes are shown as black circles. An additional subset of 17, 10-10 electrodes are shown as open circles
Figure 3
Figure 3
Rey-Osterrieth complex figure. The figure represents sample drawings from 2 study children, 1 from the Control group, a 9 year 3 month old born at 31 w 1 d GA; and 1 from the Experimental group, a 8 year 4 month old born at 31 w 4 d GA. The conditions displayed are from left to right: Copy, Immediate Recall, and Delayed Recall
Figure 4
Figure 4
EEG Spectral coherence factors at school age, Control (C) (n = 8), Experimental (E) (n = 15). Head shown in vertex view, nose above, left ear to left. EEG frequency and coherence electrodes shown above head. Arrow color illustrates experimental group coherence; green = decreased, red = increased
Figure 5
Figure 5
Mean diffusivity in cortico-spinal tract (internal capsule) at 8 years. Control children, top row, experimental children, bottom row. Mean diffusivity rendered onto trajectories of the cortico-spinal tract, and color coded from red (low) to yellow (high). (Yellow and brighter orange: Higher measure of mean diffusivity; darker orange and red: Lower measure of mean diffusivity
See this image and copyright information in PMC

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