RANDOMISED TRIAL OF A PARENTING INTERVENTION DURING NEONATAL INTENSIVE CARE: OUTCOME AT 2 YEARS

Objective Previous studies of the long term efficacy of parenting interventions are inconclusive and have rarely focused on the neonatal period. We have evaluated the effectiveness of a parenting intervention in improving cognitive development in very preterm infants.

Methods 233 infants born <32 weeks gestational age, in one of six centres, were recruited to a cluster randomised controlled trial with a crossover design and a three month washout period. Parents in the control group received standard care and parents in the intervention group received the nurse-delivered ‘Parent Baby Interaction Programme’ (PBIP) during the neonatal period and up to six weeks post-discharge. Groups were well matched for baseline maternal and infant characteristics. Cognitive development was assessed at 2 years corrected age by psychologists using the Mental Development Index (MDI) of the Bayley Scales of Infant Development II (BSID-II).

Results 112 infants were recruited in the intervention phases and 121 in the control phases. 195 (84%) were assessed at 2 years. Mean MDI scores did not differ between the intervention (90.9, SD 19.4) and control (92.5, SD 19.2) groups (difference in means: −0.9, 95% CI −5.7 to 3.9). Subgroup analyses revealed positive but non-significant effects of intervention for babies born <28 weeks gestational age and for unsupported mothers.

Conclusions We did not detect a beneficial effect of this early parenting intervention on cognitive development at 2 years in very preterm infants. Parenting interventions may be more beneficial if targeted to vulnerable groups and if commenced after discharge.