Bedside counseling aimed at boosting the emotional connection between moms and their newborns was associated with better neurodevelopmental outcomes among preterm babies, according to a trial from Finland.
Infants (average age 30 weeks’ gestation) whose mothers participated in the Family Nurture Intervention (FNI) experienced frequency-specific network effects in the brain, mainly observed in the alpha frequency of the fronto-central cortical regions, reported Pauliina Yrjölä, MsC, of Helsinki University Hospital, and colleagues.
FNI bedside counseling fosters an emotional connection after birth. The frequency-specific changes with the intervention were linked with improved cognitive and language outcomes at 18 months, the researchers wrote in Science Translational Medicine.
The program affected development of large-scale cortical networks as opposed to maturation of local neuronal activity, Yrjölä and co-authors stated, noting that neurodevelopmental outcomes among preterm babies in FNI were comparable to healthy babies born at term.
They added that “comparison of these networks to healthy infants born at full-term age suggests that the intervention may overcome the adverse network effects of early prematurity.”
Although much early brain development occurs in utero, babies born preterm spend a portion of their critical development period in the neonatal ICU, a highly unnatural environment, Yrjölä and colleagues noted. “It is now well established that prematurity links to a cascade of adverse neurodevelopmental sequelae, making it one of the key global challenges in medicine,” they wrote.
The trial included 59 mother-infant pairs. Details on patient demographics were outlined in a 2014 Clinical Neurophysiology study.
Yrjölä and colleagues analyzed electroencephalography (EEG) recordings of babies who participated in a single-center, parallel-group randomized controlled trial of FNI. The intervention included guided sensory interactions between mother and baby, such as sustained touch, exchanging scent cloths, mothers speaking to infants frequently, and periods of eye contact. Mothers and babies participated in hour-long sessions of the program four times a week.
Brain activity networks were measured across a series of frequency bands with phase-phase correlations (PPCs), which reflect neuronal communication and are considered to underlie many higher brain functions, the researchers said.
Babies who received standard care treatment were compared with those who participated in FNI plus standard care. The researchers collected 5-minute EEG recordings during two sleep states — active sleep and quiet sleep — to evaluate cortical activity.
To assess the relationships between brain activity to clinical outcomes, the researchers correlated mean connectivity strengths in networks of interest to scores assessed by the Bayley Scales of Infant and Toddler Development at 18 months. They also compared neurodevelopmental outcomes among preterm babies who received the intervention to healthy babies born at term.
The researchers reported that lower PPC strengths in the alpha frequency network were associated with better cognitive and language outcomes in both sleep states. Lower mean connectivity was also associated with better outcomes.
Mean connectivity strength among babies who received FNI was comparable to healthy babies born at term, whereas babies who received only standard care had higher connectivity strengths.
Study limitations included possible interactions between the two study groups, with mothers in the standard care group potentially observing some FNI activities and engaging in those behaviors.
The researchers also pointed out that “it is challenging to fully characterize the intervention from the perspective of infants; such would be essential to understand the underlying mechanisms of environmental enrichment approaches.”
The study was funded by the Finnish Pediatric Foundation, the Finnish Academy, the Juselius Foundation, Aivosäätiö, the Neuroscience Center at University of Helsinki and Helsinki University Central Hospital, and the National Health and Medical Research Council of Australia.
Yrjölä and co-authors disclosed no relationships with industry.