ORIGINAL ARTICLES

Randomised trial of parental support for families with very preterm children Avon Premature Infant Project Aim—To test the eVectiveness of a home based developmental education pro-gramme in very preterm children. Methods—A randomised controlled trial was conducted of developmental or social support intervention, started at discharge for up to 2 years, in 309 consecutive survi-vors of 32 weeks gestation or less, born to mothers resident in greater Bristol be-tweenDecember 1990 and July 1993.Home visits were made by research nurses trained in either Portage (a developmental education programme) or in non-directional counselling (parent adviser scheme). Interventions were also provided to appropriate primary care and commu-nity support for disability. GriYths Men-tal Development Scales were used to assess outcome at 2 years. Results—Mean (SEM) GriYths quotients (GQ) were: Portage 96.8 (1.6); parent adviser 95.9 (1.6); preterm control 92.9 (2.0). Despite randomisation, social vari-ables significantly confounded these re-sults. Using linear regression analysis, intervention was associated with im-proved scores: Portage: + 4.3 GQ points (95 % CI 1.6 to 7.0); parent adviser: +3.4 GQ points (1.4 to 6.1). The eVect of Portage was greatest in those children with birthweights <1250 g (+5.3 GQ points (0.2 to 10.4) and in those with an abnormal neonatal cerebral ultrasound scan (+7.3 GQ points (1.6 to 13.0). Conclusion—Primary analysis showed no developmental benefit from long term family support after preterm birth. Sec-ondary analysis controlling for the pres-ence of adverse social markers showed similar small advantage for both interven-tion groups. In the smallest infants and those with brain injuries, a structured developmental programme may oVer ad-vantage over social support intervention