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Table 1 Characteristics of included studies

From: Do NICU developmental care improve cognitive and motor outcomes for preterm infants? A systematic review and meta-analysis

Author, Year

Country

Inclusion Criteria

Gestational Age at birth(w) (Mean (SD))

Birth Weight(g) (Mean (SD))

Number of participants (Intervention, Control) (n)

Intervention Method

Intervention Delivery

Intervention Intensity

Developmental results

Abou Turk, 2009 [45]

USA

BW: 401–1500 g

C: 26.5 (1.7)I: 25.7 (1.7)

C: 924 (216)I: 806 (236)

34 (18,16)

Noise reduction

Nurse

Continuous

MDI: better in intervention PDI: ND

Als, 1994 [46]

USA

GA: 24–30 wBW: < 1250 g

C: 26.5 (1.4)I: 27.1 (1.6)

NS

38 (20,18)

NIDCAP

Nurse/Mother

Continuous

MDI: better in intervention PDI: better in intervention

Als, 2004 [47]

USA

GA: (28w + 4 d) – (33w + 3 d)

C: 31.83 (1.47)I: 31.22 (1.39)

C: 1730 (350)I: 1648 (232)

33 (18,15)

NIDCAP

Nurse/Mother

Continuous

MDI: better in intervention PDI: better in intervention

Als, 2011 [48]

USA

Severe IUGRGA: 28–33 w

C: 31.69 (2.39)I: 32.06 (2.28)

C: 1122 (336)I: 1083 (343)

30 (12,18)

NIDCAP

Nurse/Mother

Continuous

MDI: better in intervention PDI: ND

Als,2012 [49]

USA

Severe IUGR

GA: (26w + 4d) - (33w + 3d)

C: 30.40 (1.91)I: 30.76 (2.78)

C: 1048 (250)I: 997 (324)

30 (13,17)

NIDCAP

Nurse/Mother

Continuous

MDI: better in intervention PDI: ND

Ariagno, 1997 [50]

USA

GA: ≤ 30 w BW: ≤1250g

C: 26.1 (1.8) I: 26.4 (2.1)

C: 811.7 (210.8) I: 884.1 (182.0)

35 (17,18)

NIDCAP

Nurse/Mother

Continuous

MDI: ND PDI: ND

Brandon, 2017 [51]

USA

GA: ≤28 w

C: 26.3 (1.5) I: 26.3 (1.4)

C: 872.7 (232.7)

I: 874.1 (219.7)

121 (63,58)

Cycled light e

Nurse

Cycled light k

MDI: NDP DI: ND

Brown, 1980 [52]

USA

GA: ≤ 37 BW: 1000–1750 a

C:31.1 (2.9)I: 31.8 (2.4)

C: 1506 (216)I: 1564 (217)

NS

Infant stimulation, Mother training

Nurse

-5 days/week- twice daily -30 min/session

MDI: ND PDI: ND

Fajardo, 1992 [53] [54]

USA

GA: <  31 BW: <  1300 g + AGA

C: 29.75 (28–31)I: 28.75 (26–30)

C: 1108 (680–1290)I: 1052 (817–1300)

24 (12,12)

Reduce patterned stimuli f

Nurse

4 weeks from 32 to 36 weeks PCA

MDI: ND PDI: better in good state organizer

Feeley, 2012 [55]

Canada

BW: <  1500 g

C: 27.9 (2.2) I: 28.0 (2.3)

C: 979.5 (221.6)

I: 982.2 (284.1)

122 (61,61)

Cues and Care trial

Mother

1–2 sessions/ week

l

Bayley III:

Cognitive: ND Motor: ND Language: ND

Guyer, 2012 [56]

Switzerland

GA: ≤32 0/7

C: 29.5 (2.1)I: 30.6 (0.95)

C: 1284 (346) I: 1439 (299)

37 (17,20)

Cycled lighting

Nurse

Cycled light m

MDI: NDPDI: ND

Kramer, 1975 [57]

USA

GA: <  38 BW: <  1800

C: 33 I: 33

C: 1418 I: 1441

14 (8,6)

Touch, in the form of extra tactile stimulation

Nurse

- Daily for at least 2 weeks − 48 min/session

At transfer to crib MDI: better in interventionPDI: ND

At 6 weeks and 3 months: MDI: NDPDI: ND

Maguire Arch Dis Child Fetal Neonatal Ed, 2009 [58]

Netherlands

GA: < 32

C: 29.1 (1.9)I: 29.5 (1.6)

C: 1238.5 (337.2)I: 1248.4 (338.1)

192 (98,94)

Basic developmental care g

Healthcare professionals

Continuous

At 12 monthsMDI: ND

PDI: better in intervention At 24 months MDI: ND PDI: ND

Maguire PEDIATRICS, 2009 [59]

Netherlands

GA: < 32

C: 29.3 (1.6)I: 29.6 (1.5)

C: 1247 (340)I: 1263 (311)

168 (84,84)

NIDCAP

Nurse/Mother

Continuous

MDI: ND PDI: ND

McAnulty, 2009 [60]

USA

GA: < 29 BW: < 1250 b

C: 26.20 (1.42) I: 30.3 (6.2)

C: 837 (135) I: 850 (157)

107 (56,51)

NIDCAP

Nurse/Mother

Continuous

MDI: better in intervention PDI: better in intervention

Parker, 1992 [61]

USA

GA: ≤ 36

C: 33.4 (2.4) I: 30.3 (6.2)

C: 1687 (356) I: 1368 (410)

41 (56,51)

h

infant-development specialist

-4 times (2–6 sessions)/ week

At 4 months MDI: better in intervention PDI: better in intervention At 8 months MDI: better in intervention PDI: ND

Peters, 2009 [62]

Canada

GA: ≤ 32 BW: 500–1250

C: 27.0 (2.3)I: 27.5 (1.4)

C: 927.1 (204.0) I: 988.2 (183.7)

120 (60,60)

NIDCAP

Nurse/Mother

Continuous

MDI: ND PDI: ND

Powell, 1974 [63]

USA

BW: 1000–2000 g c

NS

d

NS

Handling

Healthcare professionals/Mother

n

At 2 month MDI: NDPDI: ND At 4 months MDI: better in intervention PDI: better in intervention

At 6 months MDI: ND PDI: ND

Procianoy, 2010 [64]

Brazil

GA: ≤32 BW: 750–1500

C: 29.7 (1.62)I: 30.0 (1.55)

C: 1151 (198)I: 1192 (189)

104 (52,52)

Massage therapy

Mother observation

-Four times daily-15 min/session

MDI: better in intervention PDI: ND

Szajnberg, 1987 [65]

USA

AGA GA: 28–32 w

C: 24.3 I: 25.7

NS

25 (12,13)

mother-infant observation i

Mother observation

-Only one session 30–40 min intervention at 34 weeks of age

MDI: ND PDI: ND

Welch, 2015 [66]

USA

GA: 26–34 w

C: 30.7 (2.6) I: 30.8 (2.1)

C: 1474 (439) I: 1426 (3960

150 (78, 72)

FNI j

trained NICU nurses

o

Bayley III: cognitive: better in intervention if score above 85 language: better in intervention if score above 85 motor: ND

  1. aBlack mother. b Mechanical ventilation within the first 3 h and for > 24 h in the first 48 h. c Black infants . d The stimulated Ss had a slightly higher average birth weight (1769 g as opposed to 1674 g), and a greater proportion of males (53% males as opposed to 37% male). e start at 28 versus 36 weeks PMA. f Introduce a defined day- night cycle, Emphasize state contingent nursing care. g incubator covers and positioning aids. h Enhance a mother’s ability to provide a more stimulating and nurturing environment . I mothers observation of Brazelton Neonatal Behavioral Assessment Scale that performed on their own infants. j facilitating an emotional connection between mother and premature infants. k 11-h-on, 11-h-off pattern. l 5 sessions in NICU + 1 session in Post NICU, 45 to 75 min/session. m 12-h-on, 12-houroff pattern. n Twice daily (72 h to regain the birth weight), Once daily (regain the birth weight to discharge), 20 min/ session . o Nurture Specialists facilitated FNI during mother after delivery (mean of 7 days). Nurture Specialists met with FNI mothers an average of 6.4 h/week to facilitate calming sessions
  2. C Control, I Intervention, GA Gestational age, BW Body weight, W Week, G Gram; IUGR Intrauterine Growth Restriction AGA Adequate for gestational age, NS Not specified, Bayley II, MDI (Mental Developmental Index), PDI (psychomotor developmental index) subscales, Bayley III Cognitive, language, motor subscales, PCA Post Conceptional Age, NIDCAP Newborn Individualized Developmental Care and Assessment Program FNI, Family nurture intervention; ND, No difference; NICU Neonatal Intensive Care Unit