RESUMO
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.
Assuntos
Desenvolvimento Infantil , Deficiências do Desenvolvimento/prevenção & controle , Intervenção Educacional Precoce , Comportamento do Lactente , Recém-Nascido de muito Baixo Peso , Exame Neurológico , Pré-Escolar , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Fatores de Risco , Fatores Socioeconômicos , Resultado do TratamentoRESUMO
OBJECTIVE: To determine whether the Infant Behavioral Assessment and Intervention Program (IBAIP), designed to support and enhance infants' self-regulatory competence, improved developmental and neurobehavioral outcomes in very low birth weight (VLBW) infants. STUDY DESIGN: We randomized 86 infants to 1 intervention before discharge and to 6 to 8 home interventions until 6 months corrected age, and 90 control infants received standard care. Developmental and behavioral outcomes were evaluated at 6 months corrected age with the Bayley Scales of Infant Development-II (BSID-II). Neurobehavioral functioning was evaluated with the Infant Behavioral Assessment (IBA) at baseline and at 6 months corrected age. RESULTS: Despite randomization, some differences in neonatal characteristics were found between the intervention and control infants. After adjustment, intervention effects of 7.2 points (+/- standard error 3.1) on the Mental Developmental Index and 6.4 +/- 2.4 points on the Psychomotor Developmental Index favored the intervention infants. The Behavioral Rating Scale of the BSID-II (P = .000) and the IBA (more approach [P = .003] and less stress [P = .001] over time) also favored the intervention infants. CONCLUSIONS: The IBAIP improved the mental, motor, and behavioral outcomes of VLBW infants at 6 months corrected age.