The University of Illinois at Chicago College of Nursing has received a $4.1 million federal grant to develop ways to improve the early growth and development of premature infants who have two or more social-environmental risks such as poverty or minority status.
“Approximately half a million premature infants are born each year in the United States,” said Rosemary White-Traut, head of maternal-child nursing at UIC and principal investigator of the five-year study. “Premature birth places the infant at risk for behavioral problems, feeding difficulties, developmental delays, lower childhood IQ and increased health care costs.
“Premature infants experience double jeopardy when they are born into families with two or more social-environmental risks, such as poverty, low parental education, adolescent parenthood or living in a stressful neighborhood. The family has multiple stressors and fewer resources to cope with the infant’s needs. Mothers of premature infants have heightened anxiety and difficulty learning to respond appropriately to their infant’s biologic maturity.”
The study will enroll 252 premature infants born between 29 and 34 weeks gestational age at two Chicago medical centers: Mount Sinai Hospital and Mercy Hospital. The study will use a clinical model called H-HOPE — Hospital-home transition: optimizing prematures’ environment — that combines components from two research programs previously used by White-Traut and Kathy Norr, UIC professor of maternal-child nursing, who is co-principal investigator of the new study.
During the first component, called “audio, tactile, visual and vestibular stimulation,” mothers spend 10 minutes talking to the infant, lightly stroking or massaging it and looking directly in its eyes, followed by five minutes of rocking the baby. In the second program, mothers are taught by a nurse-community advocate team about preterm infant behavior and feeding.
“Mothers have found that it’s a stressful and difficult time from 32 weeks, when premature infants begin oral feeding, through approximately one month after going home from the hospital,” White-Traut said. “Mothers have identified this time that they would benefit from ongoing support.”
H-HOPE is innovative, White-Traut said, because it is the first study to simultaneously incorporate programs for both mother and premature infants and evaluate the outcomes for both.
“The synergistic effect of the two models should lead to the infant becoming more mature at a faster rate and reducing the time of stay in the hospital,” she said. “It should also improve how a mother recognizes her premature infant’s behavioral cues, provide mothers with a greater confidence in caring for their infants, give them a more positive perception of the infant, and lower their levels of anxiety.”
If successful, H-HOPE will provide a national model for improving early infant health and development, as well as reduce health care costs, White-Traut said.
“Preterm infants have an average initial hospitalization of three weeks,” she said. “Reducing hospital stays by just three days could save more than $2 billion dollars a year.”