Abstract
BACKGROUND: A sensitive, well-functioning maternal interaction is vital for healthy infant development. For moderate to late preterm infants, this is even more important as this group of infants are at increased risk of facing neurodevelopmental disorders. The Early Collaborative Intervention supports parent-preterm infant interaction and includes three sessions, two in the hospital and one after discharge. OBJECTIVE: To investigate the impact of the Early Collaborative Intervention, compared with standard care, on mother-preterm infant interaction at one month corrected age. DESIGN: A longitudinal randomized controlled trial, reporting secondary outcomes from the first follow-up. SETTING: The intervention was conducted at a pediatric center with two neonatal intensive care units with an infant and family centered approach. The intervention was evaluated in the homes of the families. PARTICIPANTS: Families with preterm infants born in gestational week 30+0-35+6 (n = 143) were randomized. In this one-month follow up a total of 101 families participated, (standard care with the Early Collaborative Intervention, n = 60, standard care, n = 41). METHODS: The mother-infant interactive behavior was videotaped during a bath and later analyzed with Ainsworth's Maternal Sensitivity Scales and the Emotional Availability Scales. The coder was masked to group randomization as well as to demographic data of the dyads. RESULTS: In the analysis the maternal mean scores were statistically significantly higher for the intervention-group versus the standard care group in the Availability subscale, 7.30 vs 6.29 (CI 0.01-0.86, p = 0.045, Cohen's d 0.43), and Acceptance subscale, 8.00 vs 7.22 (CI 0.12-0.97, p = 0.012, Cohen's d 0.55), in the Ainsworth's Maternal Sensitivity Scales. Mean score were also statistically significantly higher for the intervention-group versus the standard care group in the Non-hostility subscale, 6.60 vs 6.12 (CI 0.11-0.97, p = 0.013, Cohen's d 0.54), in the Emotional Availability Scales. The results suggest that these aspects of maternal interactive behavior towards her infant, are the ones most influenced by the Early Collaborative Intervention. CONCLUSIONS: The Early Collaborative Intervention had beneficial impacts on maternal interactive behavior for those who took part in three sessions or more of the intervention program. REGISTRATION: The project was registered in ClinicalTrials.gov with the number: NCT02034617, registered 19/12/2013, date of the first recruitment 15/01/2014.