Background Premature infants, defined as those born before 37 weeks of gestation, are at elevated risk for neurodevelopmental delay due to incomplete organ maturation and heightened vulnerability to neurological impairment during the critical early postnatal period. Family care plays a crucial role during their growth process, yet the traditional nursing model has substantial temporal and spatial limitations. Telemedicine models offer a promising new solution for the family care of premature infants; however, existing research examining the impact of telemedicine-based interventions on neurodevelopmental outcomes has notable deficiencies, including limited sample sizes, short follow-up periods, and inconsistent outcome measures, leaving the overall effectiveness of such interventions not yet fully established. Methods This single-center randomized controlled trial enrolled 186 premature infants admitted to the neonatal department of Beijing Friendship Hospital from January 2023 to December 2024. Infants were randomly assigned to an observation group ( n = 93) or a control group ( n = 93) using a computer-generated random number table. Sample size was determined by a priori power analysis ( α = 0.05, power = 0.80) based on expected effect sizes from prior telemedicine intervention studies. The control group received routine home care according to standard hospital practice, while the observation group received additional home care guidance based on a telemedicine model, including monthly 60-minute remote video training sessions, 24/7 real-time online consultation, and weekly personalized knowledge push via WeChat. The intervention period was 6 months, beginning at hospital discharge. Blinded assessors evaluated outcomes using the Bayley Scales of Infant and Toddler Development (Third Edition), Neonatal Behavioral Neurological Assessment, Peabody Developmental Motor Scales (Second Edition), Social Adaptive Behavior Scale (infant subscales), and Neuropsychological Development Scale for Children aged 0–6 years. Daily behavioral observation indicators including sleep regularity, feeding quality, and emotional stability were recorded by parents using standardized definitions provided during training. Results After the 6-month intervention, the observation group demonstrated significantly higher scores across all domains of the Bayley Scales (cognitive: 87.6 ± 4.9 vs. 81.3 ± 4.5, Cohen's d = 1.34; language: 85.2 ± 4.6 vs. 79.1 ± 4.2, Cohen's d = 1.39; motor: 86.3 ± 4.7 vs. 80.5 ± 4.3, Cohen's d = 1.29; all P 0.001). The NBNA score (37.8 ± 1.4 vs. 35.6 ± 1.2, Cohen's d = 1.69, P 0.001), gross motor function score (88.4 ± 5.8 vs. 81.7 ± 5.0, Cohen's d = 1.24, P 0.001), fine motor function score (87.7 ± 5.6 vs. 80.3 ± 4.8, Cohen's d = 1.42, P 0.001), Social Adaptability Scale score (86.8 ± 5.3 vs. 82.6 ± 4.9, Cohen's d = 0.82, P 0.001), and Neuropsychological Development Questionnaire score (85.7 ± 5.4 vs. 79.8 ± 4.8, Cohen's d = 1.15, P 0.001) were all significantly higher in the observation group compared with the control group. Among daily behavior observation indicators, the rates of meeting standards for sleep regularity (82.8% vs. 67.7%, χ 2 = 7.917, P = 0.005), good feeding (79.6% vs. 64.5%, χ 2 = 6.356, P = 0.012), and emotional stability (86.0% vs. 72.0%, χ 2 = 7.021, P = 0.008) were significantly higher in the observation group. Conclusion Family care guidance for premature infants based on a telemedicine model can effectively improve multiple neurodevelopmental assessment indicators and daily behavioral outcomes. This intervention addresses previous research limitations by employing rigorous randomization, standardized outcome measures, and adequate sample size, thereby providing robust evidence for an efficient and convenient new approach for family care of premature infants that is worthy of clinical promotion and application.
Li et al. (Thu,) studied this question.