Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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To determine whether developmental care interventions reduce neurodevelopmental delay, poor weight gain, length of hospital stay, length of mechanical ventilation, physiologic stress, and other clinically relevant adverse outcomes in preterm infants. ⋯ In most studies, the inclusion of multiple interventions made the determination of the effect of any single intervention difficult. Although there is evidence of some benefit of developmental care interventions overall and no major harmful effects reported, there were a large number of outcomes for which no or conflicting effects were shown. The single trials that did show a significant effect of an intervention on a major clinical outcome were based on small sample sizes, and the findings often were not supported in other small trials. Before a clear direction for practice can be supported, evidence showing more consistent effects of developmental care interventions on important short- and long-term clinical outcomes is needed. The economic impact of the implementation and maintenance of developmental care practices should be considered by individual institutions.