Background

Infants born preterm are known to be at risk for abnormal brain development and adverse neurobehavioral outcomes. To improve early neurodevelopment, several non-pharmacological interventions have been developed and implemented in the neonatal intensive care unit (NICU). Sensory-based interventions seem to improve short-term neurodevelopmental outcomes in the inherently stressful NICU environment. However, how this type of intervention affects brain development in the preterm population remains unclear.

Methods

A systematic review of the literature was conducted for published studies in the past 20 years reporting the effects of early, non-pharmacological, sensory-based interventions on the neonatal brain after preterm birth.

Results

Twelve randomized controlled trials (RCT) reporting short-term effects of auditory, tactile, and multisensory interventions were included after the screening of 1202 articles. Large heterogeneity was identified among studies in relation to both types of intervention and outcomes. Three areas of focus for sensory interventions were identified: auditory-based, tactile-based, and multisensory interventions.

Conclusions

Diversity in interventions and outcome measures challenges the possibility to perform an integrative synthesis of results and to translate these for evidence-based clinical practice. This review identifies gaps in the literature and methodological challenges for the implementation of RCTs of sensory interventions in the NICU.

Impact

• This paper represents the first systematic review to investigate the effect of non-pharmacological, sensory-based interventions in the NICU on neonatal brain development.

• Although reviewed RCTs present evidence on the impact of such interventions on the neonatal brain following preterm birth, it is not yet possible to formulate clear guidelines for clinical practice.

• This review integrates existing literature on the effect of sensory-based interventions on the brain after preterm birth and identifies methodological challenges for the conduction of high-quality RCTs.

中文翻译：

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NICU 中基于感觉的干预：系统评价对早产大脑发育的影响

背景

众所周知，早产婴儿存在大脑发育异常和不良神经行为结果的风险。为了改善早期神经发育，已经在新生儿重症监护病房 (NICU) 开发和实施了几种非药物干预措施。基于感觉的干预似乎可以改善固有压力 NICU 环境中的短期神经发育结果。然而，这种类型的干预如何影响早产人群的大脑发育仍不清楚。

方法

对过去 20 年发表的研究文献进行了系统回顾，这些研究报告了早产后早期、非药物、基于感觉的干预措施对新生儿大脑的影响。

结果

在筛选了 1202 篇文章后，纳入了 12 项报告听觉、触觉和多感官干预的短期影响的随机对照试验 (RCT)。在涉及干预类型和结果的研究中发现了很大的异质性。确定了感官干预的三个重点领域：基于听觉的、基于触觉的和多感官干预。

结论

干预措施和结果测量的多样性挑战了对结果进行综合综合并将其转化为循证临床实践的可能性。本综述确定了 NICU 感觉干预 RCT 实施的文献空白和方法学挑战。

影响

• 本文是第一篇系统评价，旨在调查 NICU 中基于感觉的非药物干预措施对新生儿大脑发育的影响。

• 尽管回顾的随机对照试验提供了此类干预措施对早产后新生儿大脑影响的证据，但尚无法为临床实践制定明确的指南。

• 这篇综述整合了现有的关于基于感觉的干预对早产后大脑影响的文献，并确定了进行高质量 RCT 的方法学挑战。