Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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Effect of Neonatal Developmental Intervention Program (NDT) on Motor Development and Growth in Premature Infants

  • Park, Geun-Hwa (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Choi, Sang-Youn (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Kim, Sung-Mi (Department of Pediatrics, Busan St. Mary's Medical Center) ;
  • Kim, Mi-Ae (Department of Rehabilitation Medicine, Busan St. Mary's Medical Center) ;
  • Lee, Eun-Ju (Department of Rehabilitation Medicine, Busan St. Mary's Medical Center)
  • Published : 2010.11.30
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Abstract

Purpose: The aim of this study was to identify the effects of neonatal developmental intervention program (NDT) in promoting motor development and growth and to determine the usefulness of Hammersmith Neonatal Neurological Examination (HNNE) and Neonatal Behavioral Assessment Scale (NBAS) in premature infants. Methods: We performed NDT on selected premature infants (PI, n=42) and compared them with the full term control group (FC, n=20). NDT protocol and development assessment (HNNE, NBAS) were manipulated by the physical therapist in the neonatal intensive care unit. The data of this study were collected prospectively. Results: The PI with GA <34 weeks (VPI) subgroup showed a more use of mechanical ventilator and surfactant, severe bronchopulmonary dysplasia and intraventricular hemorrhage, and patent ductus arteriosus treated surgically than the PI with GA $\geq$34 weeks but less than 37 weeks (LPI) subgroup. The average scores improved significantly in the PI group between the 1st, 2nd, and 3rd assessment by repeated measure (P=0.000). Also, the PI group showed significantly higher total scores and average score at 40 weeks postmenstrual age, P=0.000, respectively than in the FC group. The LPI subgroup showed more weight gain and change in the head circumference between the 1st and 3rd assessment by repeated measure, respectively, P<0.05. The PI group showed no apnea, bradycardia and late sepsis associated with intervention and assessment. Conclusion: The NDT might be a safe and useful intervention to promote motor and growth outcomes in premature infants. Also, the HNNE and NBAS might be safe and useful tools for assessing neurodevelopment in premature infants.

목적: 본 연구의 목적은 미숙아에게 조기 중재 프로그램을 시행할 때 운동 발달과 성장에 미치는 효과와 발달 평가 도구(NBAS, HNNE)의 유용성을 조사하고자 하였다. 방법: 부산성모병원에서 태어난 42명의 미숙아와 부산성모병원과 좋은문화병원에서 태어난 20명의 만삭아를 대상으로 하였다. 조기 중재 프로그램과 발달 평가는 신생아 중환자실 물리치료사에 의해 시행되었다. 자료는 전향적으로 수집되었다. 결과: 재태주령 34주 미만의 미숙아 중재 그룹에서 인공호흡기와 폐표면활성제 사용, 심한 기관지 폐 이형성증, 뇌실 내 출혈, 수술을 시행한 동맥관 개존증이 재태주령 34주 이상 37주 미만 미숙아 중재 그룹보다 많았다. 미숙아 중재 그룹은 1번째, 2번째, 3번째 평가에서 NBAS와 HNNE 평균 점수의 향상을 보였다 (P=0.000). 미숙아 중재 그룹은 재태주령 40주 평가에서 만삭아 대조 그룹에 비해 더 높은 NBAS와 HNNE 평균 점수를 보였다(P=0.000). 재태주령 34주 이상 37주 미만 미숙아 중재 그룹은 1번째와 3번째 평가 사이에 체중과 두위의 더 많은 성장을 보였다(P<0.05). 미숙아 중재 그룹은 중재와 평가 중 무호흡, 서맥, 후기 패혈증이 없었다. 결론: 조기 중재 프로그램은 미숙아의 운동 발달과 성장에 양호한 영향을 미쳤다. 발달 평가 도구(NBAS, HNNE)는 미숙아의 운동 발달을 평가하는 안전하고 유용한 도구로 사용될 수 있다고 생각한다.

Keywords

References

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