587 - Neurodevelopmental Impact of Early Parent-Guided Interventions in Very Preterm Children: A School-Age Follow-up from a Randomized Controlled Trial

Publication Number: 587.5807

Mariana Lenz. Tarouco, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Renato S. Procianoy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Thomas Michael O'Shea, University of North Carolina at Chapel H, Chapel Hill, NC, United States; Rita C. Silveira, HCPA/UFRGS, Porto Alegre, Rio Grande do Sul, Brazil

Background: Children born very preterm or very low birth weight are at risk of neurodevelopmental impairment. Parent-guided early intervention can improve the neurodevelopmental outcome of very preterm infants born in low middle-income countries. However, the relationship between early intervention and executive functioning outcomes at school age has not yet been completely understood

Objective: To investigate the association between parent-guided early intervention for very preterm infants and their executive functioning outcomes at school age

Design/Methods: Using a prospective design, very preterm infants were randomized to Enhanced Developmental Intervention (EDI) or Usual Care (UC) and completed the Bayley Scales of Infant and Toddler Development–Third Edition at 18 months of age (RCT, NCT02835612). At school age, attention and executive functions domains were assessed with the developmental NEuroPSYchological assessment second edition (NEPSY-II). Patients with severe CP, deafness and blindness were excluded from the final analysis. To describe associations, we presented mean differences or relative risks and respective 95% CIs according to the variable analyzed. Two-sided P≤.05 indicated statistical significance.

Results: Follow-up adherence was high, with all families evaluated at 18 months CA returning for neurodevelopmental assessment at school age (n=80, mean age=7 years). Family, maternal, neonatal, and clinical characteristics were similar between EDI and UC groups, though post-NICU hospitalizations up to school age were significantly higher in UC (38, 76%) compared to EDI (8, 17.4%; p< 0.001). Compared to UC group, children from EDI had better performance on the following tests: selective auditory attention and vigilance (mean=9.93, SD=4.31), organization and planning (mean=10.18, SD=3.37), inhibitory control and cognitive flexibility (mean=12.73, SD=1.32) and motor persistence and inhibition (mean=13.12, SD=1.77).

Conclusion(s): Enhanced Developmental Intervention, beginning in the NICU and continued through home-based support, showed a trend toward improved executive functioning at school age in children from low middle-income families born preterm. This intervention highlights sustained neurodevelopmental benefits and potential positive effects in other areas, such as academic performance and social-emotional health, suggesting a need to explore its effectiveness in higher-income contexts

Table: Comparison of NEPSY-II Attention and Executive Functioning Scores by Randomization Group
Table abstract PAS2025 .pdf