18-Month Follow-Up of Infants Cared for in a Single-Family Room Neonatal Intensive Care Unit

Barry M Lester; Amy L Salisbury; Katheleen Hawes; Lynne M Dansereau; Rosemarie Bigsby; Abbot Laptook; Marybeth Taub; Linda L Lagasse; Betty R Vohr; James F Padbury

doi:10.1016/j.jpeds.2016.06.069

18-Month Follow-Up of Infants Cared for in a Single-Family Room Neonatal Intensive Care Unit

J Pediatr. 2016 Oct:177:84-89. doi: 10.1016/j.jpeds.2016.06.069. Epub 2016 Jul 26.

Authors

Affiliations

¹ Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Providence, RI; Departments of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI; Departments of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI. Electronic address: Barry_Lester@Brown.edu.
² Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Providence, RI; Departments of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI.
³ Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI.
⁴ Departments of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI; Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI.
⁵ Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, RI.

PMID: 27470693
DOI: 10.1016/j.jpeds.2016.06.069

Abstract

Objectives: To determine whether the single-family room (SFR)-neonatal intensive care unit (NICU) is associated with improved 18-month neurodevelopmental outcome, especially in infants of mothers with high maternal involvement.

Study design: An 18-month follow-up was undertaken that compared infants born <30 weeks gestational age; 123 from a SFR-NICU vs 93 from an open-bay NICU. Infants were divided into high vs low maternal involvement based on days/week of kangaroo care, breast/bottle feeding, and maternal care. Infants with high vs low maternal involvement in the SFR and open-bay NICUs were compared on the Bayley Cognitive, Language, and Motor scores and Pervasive Developmental Disorders autism screen.

Results: There were more mothers in the high maternal involvement SFR than in the high maternal involvement open-bay group (P = .002). Infants with high maternal involvement in both NICUs had greater Cognitive (P = .029) and Language (P < .000) scores than infants with low maternal involvement. Effect sizes within NICU were moderate to large in the SFR-NICU for Language scores and moderate for the Language composite in the open-bay NICU. The number of days of maternal involvement was greater in the SFR than open-bay NICU (P < .000), and length of stay was shorter in the high maternal involvement SFR than high maternal involvement open-bay NICU (P = .024). Kangaroo and maternal care predicted Cognitive (kangaroo, P = .003) and Language scores (P = .015, P = .032, respectively). Infants with ≥1 symptom of autism were more likely to be in the open-bay low maternal involvement group vs the SFR high maternal involvement group (OR = 4.91, 95% CI = 2.2-11.1).

Conclusions: High maternal involvement is associated with improved 18-month neurodevelopmental outcome, especially in infants cared for in a SFR-NICU.

Keywords: follow-up; longitudinal; maternal involvement; neurobehavioral outcome; preterm infant; single-family room NICU.

MeSH terms

Child Development*
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Infant, Premature / growth & development*
Infant, Premature / psychology
Intensive Care Units, Neonatal / statistics & numerical data*
Male
Mothers / psychology