Neurodevelopmental Outcomes at Two Years’ Corrected Age of Very Preterm Infants after Implementation of a Post-Discharge Responsive Parenting Intervention Program (TOP Program) - 17/06/23
on behalf of the
SToP-BPD and the TOP program study group∗
Abstract |
Objective |
To compare neurodevelopmental outcomes at 2 years corrected age (CA) between infants born very preterm (VP) who did or did not receive a postdischarge responsive parenting intervention (Transmural developmental support for very preterm infants and their parents [TOP program]) between discharge home and 12 months’ CA.
Study design |
The Systemic Hydrocortisone to Prevent Bronchopulmonary Dysplasia (SToP-BPD) study showed no differences between treatment groups in motor and cognitive development using the Dutch Bayley Scales of Infant Development and behavior using the Child Behavior Checklist at 2 years’ CA. During its study period, the TOP program was gradually scaled up nationwide in the same population, providing an opportunity to evaluate the effect of this program on neurodevelopmental outcome, after adjusting for baseline differences.
Results |
Among 262 surviving VP infants in the SToP-BPD study, 35% received the TOP program. Infants in the TOP group had a significantly lower incidence of a cognitive score < 85 (20.3% vs 35.2%; adjusted absolute risk reduction: −14.1% [95% CI: −27.2 to −1.1]; P = .03), and a significantly higher mean cognitive score (96.7 ± 13.8), compared with the non-TOP group (92.0 ± 17.5; crude mean difference: 4.7 [95% CI: 0.3 to 9.2]; P = .03). No significant differences were found on motor scores. For behavior problems, a small but statistically significant effect for anxious/depressive problems was found in the TOP group (50.5 vs 51.2; P = .02).
Conclusions |
VP infants supported by the TOP program from discharge until 12 months’ CA had better cognitive function at 2 years’ CA. This study demonstrates a sustained positive effect of the TOP program in VP infants.
Le texte complet de cet article est disponible en PDF.Keywords : very preterm infants, early intervention programs, neurodevelopmental outcomes
Abbreviations : Bayley-III-NL, BPD, CA, CBCL1½−5, CCS, CMS, DSM-IV, GA, NICU, RCT, SToP-BPD, TOP, VP
Plan
| Funding/Support: The SToP-BPD study was funded by a Project Grant from The Netherlands Organization for Health Research and Development, ZonMW Priority Medicines for Children, no. 11-32010-02. The funding agency had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. |
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| The authors declare no conflicts of interest. |
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| Clinical Trial Registration: The SToP-BPD study was registered with the Netherlands Trial Register (NTR2768; registered on 17 February 2011; 2640 ) and the European Union Clinical Trials Register (EudraCT, 2010-023777-19; registered on 2 November 2010; NL ). |
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| The results of this study were presented at the Pediatric Academic Societies Meeting 2022, Denver, United States; poster presentation; April 22, 2022. |
Vol 257
Article 113381- juin 2023 Retour au numéro
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