Randomised trial of parental support for families with very preterm children: Outcome at 5 years

Samantha Johnson ¹, Wendy Ring ², Pat Anderson ³ and Neil Marlow ^1*

¹ University of Nottingham, United Kingdom
² University of Bristol, United Kingdom
³ Univeristy of Bristol, United Kingdom

^* To whom correspondence should be addressed. E-mail: neil.marlow{at}nottingham.ac.uk.

Accepted 2 May 2005

Abstract

Objective:To test the effectiveness of a home based developmental education intervention in improving outcome at 5 years for very preterm infants.

Methods:The Avon Premature Infant Project (APIP) is a randomised controlled trial in which the parents of 284 babies born <33w gestational age received a developmental education programme, a social support intervention, or standard care. A term reference population was also recruited. This study reports outcomes at 5 years (mean age: 58m 15d) for 187 (66%) of these children without disability. Outcomes were assessed using the British Ability Scales II for cognitive development, the Movement ABC for motor impairment, and the Child Behavior Checklist for behavioural problems.

Results:Preterm infants showed poorer cognitive performance than their term peers. Mean (SD) GCA scores were: Portage 99.2 (15.7); Parent Adviser 100.3 (14.8); preterm control 101.1 (15.0); term reference 107.2 (13.4). There were no significant differences between preterm groups in GCA scores indicating no effect of either intervention. Similarly, there was no significant effect of intervention on behavioural or motor outcomes. Further analyses, in which outcome data were adjusted for social factors, did not reveal any differences between the three preterm groups or by subgroups classified by a range of perinatal variables.

Conclusion:The small advantage demonstrated at 2 years of age is no longer detectable at 5 years. These results question the effectiveness of early intervention in enhancing cognitive, behavioural, and motor function at 5 years.

Keywords: home-based developmental education programme, family support, cognitive development, motor impairment, behaviour

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