Effect Of Early Intervention On The Improvement Of Intellectual And Motor Development Of Very Low Birth Weight Premature Infants

Objectives:To discuss the effect of early intervention on the improvement of the intellectual and motor development of very low birth weight premature infants.Methods:1. The clinical datas of60premature infants with gestational age less than32weeks or birth weight less than1500grams, hospitalized in our neonatal intensive care unit were collected from September2011to December2012. According to the time of outpatient follow-up, the premature infants were divided into two groups:routine group of30premature infants and intervention group of30premature infants. For the premature infants of intervention group, outpatient follow-ups must be more than9times from discharge to12months of corrected age. For the premature infants of routine group, outpatient follow-ups were less than3times from discharge to12months of corrected age. The datas of two groups were statistically analyzed.2. In the intervention group, when the premature infants’condition were stable, they received early intervention, including touch、 visual and auditory stimulation. After discharge from hospital, the premature infants not only received the regular outpatient follow-up and routine care, but also received comprehensive early intervention with parental involvement. Parents were trained how to improve the cognitive, language, communication skills of the infants, and how to give the full-body massage, passive gymnastics and active exercise to infants, who received regular neuromotor assessment. In the routine group, infants just received similar routine care. The physical development of all premature infants were evaluated at corrected age of12months, including head circumference, body height and body weight. The intellectual and motor development of premature infants were evaluated at corrected gestational age of12months by Bayley scales of infant development. Test results of the Bayley scales of infant development were expressed by Mental development index (MDI) and Psycho-motor development index (PDI). The datas of two groups were statistically analyzed.Results:1. Among the clinical datas, gender、 gestational age、birth weigh、 hearing test、 pregnancy complications of mathers、 parental education level and childbearing age of mothers, the incidence of twin pregnancy、 small for gestational age infants、 fetal distress、 umbilical cord and placental abnormalities、 asphyxia、Respiratory distress syndrome (RDS)、 neonatal anemia、 neonatal sepsis、 patent ductus arteriosus、 neonatal hypoglycemia、 retinopathy of prematurity、 extrauterine growth retardation at discharge in two groups had no significant difference.2. There was no infant suffered from cerebral palsy in tow groups at corrected age of12months. The MDI and PDI scores of infants in intervention group scored higher than those of infants in routine group, with statistic significance (P<0.05). The average scores of MDI and PDI of infants were5.18points in intervention group, and6.01points higher than those in routine group. The scores of infants in intervention group showed a trend towards moderate level, while the scores of infants in routine group located in the lower level from the distribution of PDI and MDI.3. The head circumference, body length and body weight of infants in routine group were lower than those of infants in intervention group, and the difference was statistically significant (P<0.05). The head circumference, body length and body weight of infants in intervention group were0.416kg，1.4cm and0.529cm higher than those of infants in routine group. 4. Catch-up growth of preterm infants in two groups was compared at corrected age of12months:With regarding to body weight,25infants of intervention group completed catch-up growth (83.3%),16infants of routine group completed catch-up growth (53.3%). With regarding to length,26infants of intervention group completed catch-up growth (86.7%),17infants of routine group completed catch-up growth (56.7%); With regarding to head circumference,27infants of intervention group completed catch-up growth (90%),20infants of routine group completed catch-up growth (66.7%). The differences were all statistically significant (P<0.05). Results showed that the catch-up growth of infants in intervention group were better than those of infants in routine group.Conclusion:1. Early intervention since after birth could improve the intellectual and motor development of very low birth weight premature infants.2. Early intervention since after birth could promote the physical growth of very low birth weight premature infants.3. Family-centered early individual intervention for VLBW infants was a feasible and effective measure. This measure was economic and practical at the same time.