Clinical Research Directory

Effects of a Multisensory Intervention Program on the Term Behavior of the Very Premature Baby

The growth and organization of the cerebral cortex is ensured by the oligodendrocyte-rich subplate, whose proper development depends on both subcortical structures and sensory experiences. In the incubator, the premature baby is exposed to inappropriate stimuli at a critical period of physiological immaturity and brain development. Analysis of the pathophysiological basis of neurological and behavioral disorders in premature infants highlights the interplay between biological vulnerability (cerebral alteration) and environmental factors (stress, perinatal pain and loss of emotional connection with the mother). Developmental care aims to modify the environment in order to limit deviant developmental trajectories and reduce neurobehavioral impact, by relying on brain plasticity. This care consists of a set of environmental and behavioral strategies based on principles of balance between different stimuli adapted to cerebral maturation. The usefulness of multimodal sensory interventions as early as 28 weeks of amenorrhea has been demonstrated to offset the harmful effects of incubator dystimulation. These interventions improve neurobehavioral disorders and reduce parental stress, but none has been shown to be superior. Welch's studies published in 2015 and 2017, based on the definition of emotional co-regulation processes, show the value of involving parents in care during hospitalization, from the incubator period onwards. The hypothesis of this study is that multisensory intervention in a calming cycle can induce neurobehavioral improvement at term age in the very premature baby. The intervention consists of a parenting workshop and an incubator-based multisensory solicitation program with tactile, vestibular, visual and vocal contact performed by the mother or, where appropriate, the father, combined with the diffusion of maternal odor. The aim is to evaluate the effectiveness of this multisensory intervention on the behavior at term (in corrected age) of the very premature baby born between 24 and 32 weeks of amenorrhea.