早期介入計劃對於極低出生體重早產兒餵奶時之互動行為與心跳變異性效果

Abstract

Purpose: This study was aimed to examine the effectiveness of early intervention for very low birth weight (VLBW, birth weight <1,500 g) preterm infants in mother-infant feeding interaction at 4 and 6 months corrected age. Methods: This study enrolled 62 term infants and 179 VLBW infants that the latter were randomly assigned into usual care program (UCP), clinic-based intervention program (CBIP) and home-based intervention (HBIP) group. Mother-infant dyads feeding activity were examined using the Assessment of Mother Infant Sensitivity- Chinese version (AMIS-C). Infants’ heart rate variability (HRV) was assessed using an electrocardiography at 4 and 6 months corrected age. Results: For interactive behavior, the CBIP group showed significantly higher maternal scores on the AMIS-C than the HBIP at 4 and 6 months corrected age (p = 0.004); whereas, the infant, dyadic and total scores of all groups were comparable. As for the physiological response, all groups showed similar HRV at baseline and during feeding at 6 months corrected age. Furthermore, a higher AMIS-C dyadic and total score on at 4 months were associated with a smaller change in some HRV indices from baseline to feeding at 6 months in all groups (all r=-0.16, p<0.05). A higher AMIS-C maternal and total score on at 6 months was each associated with a smaller change in some HRV indices from baseline to feeding at 6 months (r=-0.20 to -0.16, all p<0.05). Conclusion: VLBW preterm dyads showed comparable interactive behavior and infant’s heart rate variable than term dyads during feeding at 4 and 6 months corrected age. Early intervention delivered at clinic visit was more beneficial than that delivered at home in altering maternal feeding behavior during the follow-up period.