TY - JOUR
T1 - Neurodevelopmental Outcomes at Two Years’ Corrected Age of Very Preterm Infants after Implementation of a Post-Discharge Responsive Parenting Intervention Program (TOP Program)
AU - Halbmeijer, Nienke M.
AU - SToP-BPD and the TOP program study group
AU - Jeukens-Visser, Martine
AU - Onland, Wes
AU - Flierman, Monique
AU - van Kaam, Anton H.
AU - Leemhuis, Aleid
N1 - Funding Information: 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. Publisher Copyright: © 2023 The Author(s)
PY - 2023/6
Y1 - 2023/6
N2 - 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.
AB - 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.
KW - early intervention programs
KW - neurodevelopmental outcomes
KW - very preterm infants
UR - http://www.scopus.com/inward/record.url?scp=85151275160&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jpeds.2023.02.025
DO - https://doi.org/10.1016/j.jpeds.2023.02.025
M3 - Article
C2 - 36889631
SN - 0022-3476
VL - 257
JO - Journal of pediatrics
JF - Journal of pediatrics
M1 - 113381
ER -