Early Intervention in Low-Birth-Weight Premature Infants
Results Through Age 5 Years From the Infant Health and Development Program
- Jeanne Brooks-Gunn, PhD;
- Cecilia M. McCarton, MD;
- Patrick H. Casey, MD;
- Marie C. McCormick, MD, ScD;
- Charles R. Bauer, MD;
- Judy C. Bernbaum, MD;
- Jon Tyson, MD;
- Mark Swanson, MD;
- Forrest C. Bennett, MD;
- David T. Scott, PhD;
- James Tonascia, PhD;
- Curtis L. Meinert, PhD;
- Phase II of the Infant Health and Development Program;
- Patrick Casey, MD;
- Kathleen Pearson;
- Vaughn Rickert, PsyD;
- Kathleen Whitmarsh-Barrett;
- Cecelia M. McCarton, MD;
- Anne Hogan;
- Christine Kenny;
- Mary Ellen Lynch;
- Maureen McElhinney;
- Wilma Spinner;
- Ina Wallace, PhD;
- Marie McCormick, MD, ScD;
- Margaret Churchill;
- Janice Ware, PhD;
- Kathy Workman-Daniels;
- Charles Bauer, MD;
- Allan Anfinson, PhD;
- Mary Triolo;
- Yvonne Torna;
- Judy C. Bernbaum, MD;
- JoAnn D'Agostino, MSN, CRNP;
- Pat Lee, MSW;
- Rosemarie Olmedo;
- Ben Silverman, MD;
- Marsha Hoffman-Williamson, PhD;
- Jon Tyson, MD;
- Mark Swanson, MD;
- Nancy, EdD;
- Jackie Hickman;
- Sondra Perry;
- Forrest C. Bennett, MD;
- Clifford J. Sells, MD;
- Jacqueline Chalmers;
- Beverly LaVeck, PhD;
- Gerald LaVeck, MD;
- Anne Leavitt, MD;
- Carol McMullin;
- Kathy Tekolste, MD;
- Kathy Tharp;
- David T. Scott, PhD;
- Bobbie Benz;
- Susan Paolillo;
- Moira Whitley;
- James Tonascia, PhD;
- Curtis L. Meinert, PhD;
- Patricia Belt;
- Kathryn Connor;
- Debra Amend-Libercci;
- Vivian Brown;
- Michele Donithan;
- Dawn Easton;
- Charlotte Gerczak;
- Jill Meinert;
- Cecelia McCarton, MD;
- Jeanne Brooks-Gunn, PhD;
- David T. Scott, PhD;
- Rosemary Deibler;
- Anita Levine;
- Sue Paolillo;
- Damon Schweitzer;
- Moira Whitley;
- Cecelia McCarton, MD;
- Jeanne Brooks-Gunn, PhD;
- Patrick Casey, MD;
- Curtis L. Meinert, PhD;
- David T. Scott, PhD;
- Sam Shapiro, BS;
- James Tonascia, PhD
- University of Arkansas for Medical Sciences, Little Rock; Albert Einstein College of Medicine, Bronx, NY; Harvard Medical School, Boston, Mass; University of Miami (Fla) School of Medicine, Miami; University of Pennsylvania School of Medicine, Philadelphia, Pa; University of Texas Health Science Center, Dallas; University of Washington School of Medicine, Seattle, Wash; Yale University School of Medicine, New Haven, Conn; The Johns Hopkins University, Baltimore, Md; Albert Einstein College of Medicine, Education Testing Service, Teachers College at Columbia University, and Yale University
- From the Center for Children and Families, Teachers College, Columbia University, New York, NY (Dr Brooks-Gunn); Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY (Dr McCarton); the Department of Pediatrics, University of Arkansas for Medical Science, Little Rock (Drs Casey and Swanson); Department of Maternal and Child Health, Harvard University School of Public Health, Boston, Mass (Dr McCormick); the Department of Pediatrics, University of Miami (Fla) School of Medicine (Dr Bauer); Children's Hospital of Philadelphia, University of Pennsylvania (Dr Bernbaum); the Department of Pediatrics, University of Texas Health Science Center, Dallas (Drs Tyson and Swanson); the Department of Pediatrics, University of Washington, Seattle (Drs Bennett and Scott); the Department of Pediatrics, Yale University, New Haven, Conn (Dr Scott); and the Department of Biostatistics, The Johns Hopkins University, Baltimore, Md (Drs Tonascia and Meinert).
Abstract
Objective. —To evaluate the persistence of effects on health and development at age 5 years of the Infant Health and Development Program, an early childhood intervention that was provided to low-birth-weight (LBW) premature infants from neonatal discharge through age 3 years.
Design. —Randomized, controlled, multicenter trial, stratified by two LBW groups: lighter (≤2000 g) and heavier (2001 to 2500 g).
Setting. —Eight socioeconomically heterogeneous clinical sites.
Participants. —Of 985 eligible infants weighing 2500 g or less and at 37 weeks' or less gestational age, 377 infants were randomly assigned to the intervention group and 608 to the follow-up only group. About two thirds of the infants in each group were in the lighter LBW stratum, and one third were in the heavier LBW stratum.
Intervention. —The intervention group received home visits (from neonatal discharge through age 3 years) as well as center-based schooling (from 1 to 3 years of age). Children in both groups received pediatric surveillance.
Main Outcome Measures. —Cognitive development, behavioral competence, and health status.
Results. —At age 5 years, the intervention group had full-scale IQ scores similar to children in the follow-up only group. However, in the heavier LBW stratum, children in the intervention group had higher full-scale IQ scores (3.7 points higher; P=.03) and higher verbal IQ scores (4.2 points higher; P=.02). No significant differences between intervention and follow-up only groups in cognitive measures at age 5 years were noted in the lighter LBW infants. The intervention and follow-up groups were similar in behavior and health measures regardless of LBW stratum.
Conclusion. —The early childhood intervention provided in the first 3 years of life had effects on heavier LBW premature infants' IQ and verbal performance at age 5 years that were not observed for lighter LBW premature infants. The intervention did not affect health or behavior at age 5 years in either LBW stratum.
(JAMA. 1994;272:1257-1262)
Footnotes
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A complete list of investigators in Phase II of the Infant Health and Development Program appears at the end of this article.
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Reprint requests to the Center for Children and Families, Teachers College, Columbia University, New York, NY 10027 (Dr Brooks-Gunn).
