A Randomized-Controlled Trial of Parent-Administered Interventions to Improve Short-Term Motor Outcomes in Hospitalized Very Low Birthweight Infants

Background: Premature infants are at increased risk for cerebral palsy (CP). Early interventions with a motor focus and administered by parents may improve motor outcomes.Aims: To evaluate the short-term motor outcomes and risk for CP in very low birthweight (VLBW) infants randomized to a multimodal intervention with a motor focus provided by parents versus usual care.Study design: Randomized controlled trial (intervention vs. usual care (control group))Subjects: Infants (<32 weeks' gestational age (GA) and/or <1500 grams birthweight) born between March 2019 and October 2020.Outcome measures: Short-term motor outcomes evaluated using the Hammersmith Infant Neurological Evaluation (HINE, primary motor outcome), the General Movement Assessment (GMA) and the Test of Infant Motor Performance (TIMP) at 3 months postmenstrual age (PMA).Results: 70 participants were enrolled (GA 28.3 ± 2.7 weeks, birthweight 1139.2±376.6 grams, 64.3% male). The in-person follow-up rate was 73%, lower than expected, in part due to COVID-19 restrictions, resulting in 25 infants (intervention) and 26 infants (control) with outcome data available for analysis. There were not a significant difference in the HINE, GMA or TIMP at 3 months PMA between groups. Sex was a significant predictor of higher HINE scores at 3 months PMA: 62.0 ± 1.3 in females vs. 55.5 ± 0.8 in males (p=0.015). No significant effect of the intervention by sex was observed.Conclusion: multimodal interventions with a motor focus and provided by parents do not improve short-term motor outcomes in VLBW infants.