CARE INTERVENTIONS THAT IMPROVE LONG-TERM NEURODEVELOPMENT OUTCOME IN NEONATES HOSPITALIZED AT A NICU: A SYSTEMATIC REVIEW

Background: Being born preterm increases the risk of neurodevelopmental disabilities. A factor that may contribute to an adverse neurodevelopment outcome is the environment of the Neonatal Intensive Care Unit (NICU). To protect the developing brain, several interventions have been introduced in the NICU over the years.
Aim: The objective of this review is to present an overview of care interventions, which can be delivered during the NICU-period, that improves long-term neurodevelopmental outcome in preterm infants.
Methods: This systematic review was conducted according to the method of the Cochrane Handbook for Systematic Reviews and the PRISMA statement. PubMed, CINAHL and Cochrane Central Register of Controlled Trials were searched in February and March of 2017. The methodological quality was assessed by using McMaster Quality Assessment.
Results: Six studies were included in this review, involving 467 infants. Two high quality studies and four of moderate methodological quality were included. The studies were categorized on intervention: massage therapy (2), environmental interventions (2) and interventions that involved parental interaction (3). Massage therapy and the parental interactions showed a significant improved neurodevelopmental outcome, measured with the Bayley Cognitive and Language Scale, second or third edition. There was insufficient evidence found for environmental interventions.
Conclusions: This systematic review resulted in interventions that improves neurodevelopmental outcome in infants hospitalized at a NICU. Massage therapy and interventions which involved parental interaction appeared to be the most promising interventions that might improve long-term neurodevelopment