Integrated Mother-Premature Infant Intervention and Mother-Infant Interaction at 6-Week Corrected Age

Objective: To examine whether an integrated intervention for mother–premature infant dyads relates to more positive mother–infant interaction at 6-week corrected age (CA). Design: Prospective randomized clinical trial. Setting: Two community hospital neonatal intensive care units. Sample: The sample included (N = 142) otherwise healthy infants, 29- to 34-week gestational age at birth, whose mothers reported at least two of 10 social-environmental risk factors, for example, poverty, minority status. Methods: Mother–infant dyads were randomly assigned to a control group or the H-HOPE group, which provided an integrated intervention that included twice-daily infant stimulation using the auditory, tactile, visual, and vestibular rocking stimulation and four maternal participatory guidance sessions by a nurse-community member team. Mother–infant interaction was assessed at 6-week CA using the Nursing Child Assessment Satellite Training–Feeding Scale (NCAST, 76 items) and the Dyadic Mutuality Code (DMC, six-item contingency scale during a 5-minute play session). The control and H-HOPE groups were compared using chi-square tests to assess the proportion with high DMC scores, and t-tests and multivariable linear regression to assess Overall NCAST and Maternal and Infant NCAST subscores. Results: The H-HOPE group (n = 66) trended toward higher NCAST scores overall as well as the Social-Emotional Growth Fostering Subscale than the control group (n = 76). H-HOPE infants had significantly higher scores for the overall infant subscale (p =.05) and the Clarity of Cues Subscale. The H-HOPE dyads were also more likely to have high responsiveness per the DMC (67.6% vs. 58.1% of controls). After adjustment for trait anxiety and infant morbidity scores, H-HOPE dyads had marginally higher scores on overall mother–infant interaction during feeding than controls (β = 2.03, p =.06). Conclusion/Implications for Nursing Practice: H-HOPE infants presented clearer behavioral cues and had higher mutual responsiveness with their mothers during play. Intervening with mother and infant is a promising approach to help premature infants achieve the social interaction patterns essential for optimal development. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses