Does Early Intervention Programs Help Prevent Motor and Cognitive Impairment In Preterm Infants Post-Discharge From NICU?

Does Early Intervention Programs Help Prevent Motor and Cognitive Impairment In Preterm Infants Post-Discharge From NICU?

It is clear that preterm infants are at increased risk for neurodevelopmental delays compared to infants born at term1. Therefore, a number of developmental intervention programs have been introduced in the neonatal intensive care unit setting to help the extremely low birth weight (<1000 grams birth weight) to improve the functional outcomes. Many studies are since then conducted to evaluate the long-term benefits from these intervention programs.
Cochrane neonatal group (a premier evidence-based research organization of the country) recently evaluated the utility of these programs in a meta-analysis. The group appraised 25 studies published until 2015 on this topic and selected 12 studies after applying stringent criteria for bias, randomization, and appropriate allocation. The team published their results in November 2015.
Authors’ conclusions are as follows: “Early intervention programs for preterm infants have a positive influence on cognitive and motor outcomes during infancy, with cognitive benefits persisting into preschool age. With regards to motor outcomes, a meta-analysis of 12 studies showed a significant effect in favor of early developmental interventions at infancy only. The early developmental intervention programs described in this review had to begin within the first 12 months of life, had to focus on the parent-infant relationship and/or infant development and although they could begin while the baby was still in the hospital, had to include a component that was delivered post-discharge from the hospital." Though no effect was shown on cerebral palsy, the motor improvement was, however, noted.
They concluded that further research is needed to determine which early developmental interventions are most effective in improving cognitive and motor outcomes, and to discern the longer-term effects of these programs.
It is quite encouraging that these programs do have a positive impact on the outcomes in preterm infants. We hope more and more parents of high-risk preterm infants take advantage of these early developmental intervention programs provided.

1) http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005495.pub4/abstract;jsessionid=0F403A87FD4F8ADAF80D0C3A06B49678.f02t02.

Ethereal Brew

Ethereal Brew
It has been 33 years since I have seen many of my friends from medical school. That thought brought a combination of elation and hesitation. One part of me was delighted, and the other trepidatious. How will I be received? Will I be disheartened or cheered? With the understanding that all of us are matured, and prosperous, I became more optimistic. The journey to San Diego began along the Pacific Coast Highway.
The route was so breathtaking that we could not bear forsaking. Mesmerized by the bewitching beach, my better-half walked down the pebbly path to quench her desire to drench in the ocean waves. She wandered towards the rocky cliffs, ignoring the signs of rip currents. I had no desire to wet even my feet, let alone my seat. As my spouse gleefully drifted towards the perilous Pacific risking the rip tides, I rushed behind her screaming her to halt. Suddenly, it seemed the ocean had a different notion and made a rapid motion with full emotion to abruptly stop my locomotion. It just didn't wet my feet but gave my torso, a salty treat, coercing me to join her. I held on to the blocks of rocks politely declining the active solicitation. The Pacific pacified later. Soaked in salt water, I glanced at my wife; she looked arid, and I felt horrid. Oblivious to the happening, reveling in Pacific roar, sultana turned around with a stunning smile swaying over her scintillating face, innocently inquiring, why am I wet? She was calm, but I needed a balm. She looked serene, and I needed dry-clean.

I had to abandon my shoes and drive bare feet. As we reached the reunion destination, I could feel the palpitation from excitation, as our congregation is going to end the long duration of separation. Everyone was still recognizable and delightful despite donning different shapes. An atmosphere of childish excitement prevailed.

As friends began to open up, lives began to unveil; we felt sad at what some of our buddies had to go through. In the end, they didn’t become casualties to the calamities but instead became champions of the conflicts; bricks the life threw at them. We admired their resilience. Though we were not part of their tribulations; we happily partook in their adulation. Everyone excelled in their fields.

Some went beyond the call of their duty and served in dangerous areas. Others offered voluntary services to uplift the downtrodden.

We were eager to appreciate, acknowledge others’ success, and even look up to them as role models. That signaled how much we have grown as better humans. Bidding goodbye was never easy. So, Divesh suggested we go for a hike. I wished it was on a bike. Alas, everyone wanted a walk and talked. We soon realized that we went very far. The terrain was rugged, and soles of my new cheap shoes were jagged. The rocks were hurting, and my legs were exerting. My pace decelerated. Then came the astounding announcement that rattlesnakes infested the area. I could neither run nor remain placid. I comprehended why Divesh became a proficient runner in this place. He became my instant idol and tried to emulate him, as the fear was gripping and galvanizing. He made bidding goodbye very easy for me. Maybe, our Indian marathon athletes should train here. They would become unbeatable and of course unstoppable.

We then drove to Palm Springs. A major part of the drive was very windy. When we stopped at the rest area, a bemused traveler pointed out at the thousands of windmills installed along the highway, wondering why people waste so much of money just to experience some breeze in the hot desert. His innocent incomprehension was insightful. I almost fainted. He thought it was from the heat!

After we had checked into the resort, we went for some snacks. I noticed a couple sitting outside beneath a beautiful umbrella. The husband had ordered some tea, and the waiter brought him the same. Just then a bird sat on the edge of the umbrella and enjoyed its pleasure of elimination. That fell right into the tea cup, unnoticed by the husband. As the man sipped the newly re-created tea, he was thrilled by the out of the world flavor, and profusely thanked the waiter, who was clueless.

The now hysterical husband went on to compel his innocent-half to savor the new flavor. He went for the server to find out what type of tea it was. In the meantime, the bird wanted to relive its pleasurable expulsion, dropped its droppings into the cup as the wise-half watched. Furious, she beckoned her jubilant-half to convince him to buy the birdie and not the tea from the resort for his ethereal experience of the exquisite bird brew.