PremieStart

In 2007 there were 21,357 preterm births in Australia, and more than 50% of these infants will display enduring neurobehavioural disabilities across developmental domains including problems in cognition, motor skills, emotional functioning and behaviour.

On average, infants born very preterm are SD lower on IQ at school-age, three times as likely to exhibit attention-deficit hyperactivity and at elevated risk for anxiety and depression. Early stressful experiences play a role in these poor outcomes and interventions that minimise stress on preterm infants show short-term benefits. However, a recent Cochrane Review concluded that research is urgently needed to confirm if early gains result in improved long-term neurobehavioural development to school age.

AIM: the primary aim is to evaluate the long-term effectiveness of a simple, inexpensive program of stress-reduction for preterm infants on measures of cognition and behaviour. We will compare developmental outcomes at 4 and 6 years in intervention and control preterm children, and a full-term matched cohort. A subsidiary aim is to analyse developmental outcomes in terms of perinatal variables and early brain functioning.

This is a follow-up of our recent NHMRC study which was a high-quality RCT (n=126) of our novel stress-reduction intervention. Initial results show that intervention achieved significant short-term benefits. This RCT was a larger replication of our pilot study (n=46) which found that cerebral white matter was enhanced by intervention (Milgrom et al., 2010, Pediatric Research, 67, 330-335).

We used parents as ‘change agents’ in the Neonatal Intensive Care Unit and obtained MRI brain imaging data at term-equivalent age and neurobehavioural data to 24 months. If our innovative, cost-effective program for these highly vulnerable children translates into long-term educational advantages it could, for a relatively small investment, be an invaluable advance in neonatal care and offer substantial economic benefits and improved quality of life and ensure a ‘Healthy Start to Life.’