The Journal of Pediatrics
Volume 156, Issue 3 , Pages 359-365, March 2010

A Neurobehavioral Intervention and Assessment Program in Very Low Birth Weight Infants: Outcome at 24 Months

  • Karen Koldewijn, PT

      Affiliations

    • Department of Rehabilitation, Academic Medical Center, University of Amsterdam, The Netherlands
    • Corresponding Author InformationReprint requests: Dr K. Koldewijn, Department of Rehabilitation, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
    • ,
  • Aleid van Wassenaer, MD, PhD

      Affiliations

    • Department of Neonatology, Academic Medical Center, University of Amsterdam, The Netherlands
    • ,
  • Marie-Jeanne Wolf, PhD

      Affiliations

    • Department of Rehabilitation, Academic Medical Center, University of Amsterdam, The Netherlands
    • Department of Neonatology, Academic Medical Center, University of Amsterdam, The Netherlands
    • ,
  • Dominique Meijssen, MSc

      Affiliations

    • Department of Pediatric Psychology, Tilburg University, Tilburg, The Netherlands
    • ,
  • Bregje Houtzager, MSc, PhD

      Affiliations

    • Department of Neonatology, Academic Medical Center, University of Amsterdam, The Netherlands
    • ,
  • Anita Beelen, PhD

      Affiliations

    • Department of Rehabilitation, Academic Medical Center, University of Amsterdam, The Netherlands
    • ,
  • Joke Kok, MD, PhD

      Affiliations

    • Department of Neonatology, Academic Medical Center, University of Amsterdam, The Netherlands
    • ,
  • Frans Nollet, MD, PhD

      Affiliations

    • Department of Rehabilitation, Academic Medical Center, University of Amsterdam, The Netherlands

Received 25 February 2009; received in revised form 6 July 2009; accepted 2 September 2009. published online 02 November 2009.

Objective

To determine whether the Infant Behavioral Assessment and Intervention Program (IBAIP) improves development and behavior in very low birth weight (VLBW) infants at 24-month corrected age.

Study design

In a multicenter, randomized, controlled trial 86 infants received postdischarge intervention until 6-month corrected age. The intervention consisted of supporting infants' self-regulation and development, and facilitating sensitive parent-infant interactions; 90 control infants received regular care. At 6 months, positive intervention effects were found. At 24 months, development and behavior were evaluated with the Bayley Scales of Infant Development-II (BSID-II) and the Child Behavior Check List (CBCL).

Results

Eighty-three intervention and 78 control infants were available for follow-up. After adjustment for differences in perinatal characteristics, an intervention effect of 6.4 points (± standard error, 2.4) on the Psychomotor Developmental Index favored the intervention infants. Groups did not differ on the Mental Developmental Index, the Behavioral Rating Scale of the BSID-II, or on the CBCL. Subgroup analyses revealed improved motor as well as improved mental outcomes in intervention infants with bronchopulmonary dysplasia and with combined biological and social risk factors.

Conclusions

The IBAIP shows sustained motor improvement in VLBW infants until 2-year corrected age.

VLBW, Very low birth weight, LBW, Low birth weight, IBA, Infant Behavioral Assessment, IBAIP, Infant Behavioral Assessment and Intervention Program, NIDCAP, Newborn Individualized Developmental Care and Assessment Program, BSID-II, Bayley Scales of Infant Development, BRS, Behavioral Rating Scale, MDI, Mental Developmental Index, PDI, Psychomotor Developmental Index, CBCL, Child Behavior Check List, APIP, Avon Premature Infant Project, MITP, Mother-Infant Transaction Program, BPD, Bronchopulmonary dysplasia, GA, Gestational age, PMA, Post menstrual age

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 Supported by grants from the Innovatiefonds Zorgverzekeraars (project No. 576) and ZonMw (Zorg Onderzoek Nederland) (project No. 62200032). Innovatiefonds Zorgverzekeraars supported the implementation of the intervention program, and Zorg Onderzoek Nederland supported 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 trial is registered with controlled-trials.com, number ISRCTN65503576.

PII: S0022-3476(09)00877-4

doi:10.1016/j.jpeds.2009.09.009

Refers to article:

  • Role of Intervention Strategies for At-risk Preterm Infants

    Arend F. Bos
    The Journal of Pediatrics March 2010 (Vol. 156, Issue 3, Pages 347-349)

  • Neurobehavioral Assessment Predicts Motor Outcome in Preterm Infants , 02 November 2009

    Bonnie E. Stephens, Jing Liu, Barry Lester, Linda Lagasse, Seetha Shankaran, Henrietta Bada, Charles Bauer, Abhik Das, Rosemary Higgins
    The Journal of Pediatrics March 2010 (Vol. 156, Issue 3, Pages 366-371)

The Journal of Pediatrics
Volume 156, Issue 3 , Pages 359-365, March 2010

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