Family integrated care: very preterm neurodevelopmental outcomes at 18 months

Arch Dis Child Fetal Neonatal Ed. 2022 Jan;107(1):76-81. doi: 10.1136/archdischild-2020-321055. Epub 2021 Jun 18.


Objective: To examine whether the family integrated care (FICare) programme, a multifaceted approach which enables parents to be engaged as primary caregivers in the neonatal intensive care unit, impacts infant neurodevelopment and growth at 18 months' corrected age.

Design/methods: Prospective cohort study of infants born <29 weeks' gestational age (GA) who participated in the FICare cluster randomised control trial (cRCT) and were assessed in the Canadian Neonatal Follow-Up Network (CNFUN). The primary outcome measure, Cognitive or Language composite score <85 on the Bayley-III, was compared between FICare exposed and routine care children using logistic regression, adjusted for potential confounders and employing generalised estimation equations to account for clustering of infants within sites.

Results: Of 756 infants <29 weeks' GA in the FICare cRCT, 505 were enrolled in CNFUN and 455 were assessed (238 FICare, 217 control). Compared with controls, FICare infants had significantly higher incidence of intraventricular haemorrhage (IVH) (19.5% vs 11.7%, p=0.024) and higher proportion of employed mothers (76.6% vs 73.6%, p=0.043). There was no significant difference in the odds of the primary outcome (adjusted OR: 0.92 (0.59 to 1.42) FiCare vs Control) on multivariable analyses adjusted for GA, IVH and maternal employment. However, Bayley-III Motor scores (adjusted difference in mean (95% CI) 3.87 (1.22 to 6.53) and body mass index 0.67 (0.36 to 0.99) were higher in the FICare group.

Conclusions: Very preterm infants exposed to FICare had no significant difference in incidence of cognitive or language delay but had better motor development.

Trial registration number: Participants in this cohort study were previously enrolled in a registered trial: NCT01852695.

Keywords: health services research; neonatology.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Breast Feeding
  • Canada
  • Child Development*
  • Cognitive Dysfunction / diagnosis
  • Developmental Disabilities / diagnosis
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Intensive Care, Neonatal / organization & administration*
  • Language Development Disorders / diagnosis
  • Parent-Child Relations
  • Parents* / psychology
  • Patient Care Team
  • Prospective Studies
  • Stress, Psychological / prevention & control
  • Weight Gain

Associated data