Comprehensive Overview of Preterm Developmental Supportive Care: Narrative Review
DOI:
https://doi.org/10.6000/1929-4247.2025.14.04.8Keywords:
Developmental supportive care, preterm care, neuroprotective strategies, neonatal intensive care unitAbstract
Background: Preterm infants face significant health challenges due to the underdevelopment of their organ systems. The neonatal intensive care unit (NICU) is considered a stressful environment, which can disrupt self-regulation and maturation. Developmental supportive care strategies have been shown to enhance neurodevelopmental outcomes in neonates by mimicking intrauterine conditions, reducing stress, and providing appropriate sensory stimulation. Nursing interventions, particularly developmental care, are essential in improving neonatal health, with nurses playing a pivotal role in implementing these strategies.
Aim: This article aimed to provide a comprehensive narrative synthesis of recent research on the impact of developmental supportive care on the health outcomes of preterm infants.
Methods: An extensive literature search was conducted across PubMed, Scopus, Web of Science, Google Scholar, and the Cochrane Library. Quantitative studies, quasi-experimental research, observational studies, and meta-analyses of randomized clinical trials published in English within the past decade were included, with a particular emphasis on studies from the last five years.
Results: The findings indicated that the application of developmental supportive care strategies in the neonatal intensive care unit significantly improved health outcomes for preterm infants, as reported in previous studies.
Conclusion: This narrative overview demonstrated that developmental supportive care effectively contributes to the management and enhancement of preterm infants' health. The study recommends promoting and standardizing these practices in neonatal intensive care units, conducting a collective review of developmental supportive care techniques, and establishing training programs to improve health outcomes for preterm infants and identify effective interventions.
References
World Health Organization. World Health Organization, Preterm birth. WHO 2023. https://www.who.int/news-room/fact-sheets/detail/preterm-birth (accessed February 7, 2025).
Musihb ZS. Causes of mortality in the Neonatal Intensive Care Unit: A retrospective study. Nurs Midwifery Stud 2024; 13: 191-4.
Onishi J. Epidemiology and Incidence of Preterm Delivery. In: Sameshima H, editor. Preterm Labor Deliv., Singapore: Springer Singapore; 2020; 17-25. DOI: https://doi.org/10.1007/978-981-13-9875-9_3
Al-Musawi KM, Shawq AH, Majeed Z, Zaid S, Ibraheem H. Risk Factors for Congenital Anomalies in Neonatal Intensive Care Unit in Baghdad City.Medico-Legal Update. 2020.20(1): 1168-74.
Vallepu R, Kadapa MI, Katheragandla C, Nagaraju C. Overview of the Cause, Complications, Immunity, Therapy, Medication, and Certain Behavioral Changes of Premature Babies. Arch Med Health Sci 2023; 11: 116-23. DOI: https://doi.org/10.4103/amhs.amhs_3_23
Zivaljevic J, Jovandaric MZ, Babic S, Raus M. Complications of Preterm Birth—The Importance of Care for the Outcome: A Narrative Review. Medicina (Mex) 2024; 60: 1014. DOI: https://doi.org/10.3390/medicina60061014
Shawq AH. Effectiveness of Deep Breathing Technique on Pain Level of School Children during Catheterization. Med J Babylon 2024; 21: S120-5. DOI: https://doi.org/10.4103/mjbl.mjbl_258_23
Costa M, Gaspar MF, Curado MA, Brantes A. Stress assessment instruments for hospitalized preterm newborns: scoping review. BMC Nurs 2025; 24: 79. DOI: https://doi.org/10.1186/s12912-024-02656-8
Ballantyne A., Grant A., Matta N. Developmental care guideline (964), NHSGGC Paediatrics for Health Professionals. Dev Care Guidel 964 NHSGGC Paediatr Health Prof 2021; Document Id: 964. Available from: https://clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/neonatology/developmental-care-guideline-964/?searchTerm=Developmental%20care%20guideline.
Lucas N. Developmental care in the neonatal unit. Sri Lanka J Child Health 2015; 44: 45-51. DOI: https://doi.org/10.4038/sljch.v44i1.7962
Allsop R, LemosSampaoi S, Scripps K, Carey S, James M. NHS, Clinical Guideline: Developmental Care. Guidance specific to the care of neonatal patients. East Engl Neonatal ODN UK EoE Neonatal Units 2021; NEO-ODN-2021-3: 1-41. Available from: https://eoeneonatalpccsicnetwork.nhs.uk/ neonatal/downloads/developmental-care-guideline/.
Ricciardi S, Blatz MA. Developmental care—Understanding and applying the science. In A. A. Fanaroff & J. M. Fanaroff. Klaus Fanaroffs Care High-Risk Neonate. 8th ed, India: Elsevier Health Sciences; 2025; pp. 159-77. DOI: https://doi.org/10.1016/B978-0-443-12260-6.00011-0
Sampson L, Luther M, Rolnitsky A, Ng E. Sensory Development (Not Developmental) Care Map. Children 2025; 12: 192. DOI: https://doi.org/10.3390/children12020192
Abdulzahra FA, Shawq AH. Mobile application to develop nurses’ knowledge of pediatric cardiopulmonary resuscitation: A quasi-experimental study. J Emerg Med Trauma Acute Care 2024; 2024: 1-8. DOI: https://doi.org/10.5339/jemtac.2024.absc.7
Khudhayer HF, Adulwahhab MM. The Evaluation of Nurses' Practices regarding Electronic Nursing Documentation. Iraqi Natl J Nurs Spec 2023; 36: 1-7. DOI: https://doi.org/10.58897/injns.v36i1.646
Al-Ganmi AHA, Majeed HM, Najm MA. Experiences of Nurses in Providing Care for Patients on the Cancer Journey: A Cross-Sectional Survey. Malays J Nurs MJN 2024; 16: 212-9. DOI: https://doi.org/10.31674/mjn.2024.v16i01.021
Fatmawati SA, Kompyang SNL, Hadriani H, Rizkaningsih R, Fajrillah K, Sohayla A, W. Jun CH. Creating an Innovative Curriculum for Developmental Care of Premature Infants in the NICU: Insights from a Delphi Study. Iran J Neonatol 2025; 16: 10-8. Available from: https://ijn.mums.ac.ir/article_ 25345.html
Lee H, Park JH, Cho H, Lee H, Park JH, Cho H. Analysis of research on developmentally supportive care for prematurity in neonatal intensive care unit: a scoping review. Child Health Nurs Res 2022; 28: 9-22. DOI: https://doi.org/10.4094/chnr.2022.28.1.9
Shrestha T. Developmental Supportive Care for Preterm Infants in Neonatal Intensive Care Units. J Nurs Educ Nepal 2022; 13: 117-22. DOI: https://doi.org/10.62143/vcqppg24
Hasan RT, Ali RM, Hussein EA. Effectiveness of an Educational Program on Nurses- midwives' Practices about Pain Management during Labor in Baghdad Maternity Hospitals. Indian J Forensic Med Toxicol 2020; 14: 1866-71.
Salih AH, Obaid AAR. Effectiveness of an Interventional Program on Nurses` Practices Toward Post-Operative Intravenous Infusion of Infants with Tracheoesophageal Fistula. Iraqi Natl J Nurs Spec 2023; 36: 92-9.
Yas AQA, Hattab KM. Effectiveness of Intervention Program on Nurses’ Practice toward Neonatal Endotracheal Suc-tioning Procedure. Iraqi Natl J Nurs Spec 2022; 35(2): 82-91. DOI: https://doi.org/10.58897/injns.v35i2.532
Nayef A, Neamah M. Evaluation of Nursing Performance Concerning Nasogastric Tube in Neonatal Intensive Care Unit at al-Batool Teaching Hospital in Baqubah City. Iraqi Natl J Nurs Spec 2019; 32: 47-57. DOI: https://doi.org/10.58897/injns.v32i1.323
Sakran AA, Al-Mosawi K. Effectiveness of an Educational Program on Nurse's Knowledge towards Neonatal Total Parenteral Nutrition. Iraqi Natl J Nurs Spec 2024; 37: 1-12.
Waheed NH, Abdulwahhab MM, Noor Waheed. Nurses' Knowledge and Practices concerning Physiotherapy Protocol at Intensive Care Units in AL-Nasiriyah City. Iraqi Natl J Nurs Spec 2022; 35: 102-9. DOI: https://doi.org/10.58897/injns.v35i1.488
Ferrari R. Writing narrative style literature reviews. Med Writ 2015; 24: 230-5. DOI: https://doi.org/10.1179/2047480615Z.000000000329
Green BN, Johnson CD, Adams A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. J Chiropr Med 2006; 5: 101-17. DOI: https://doi.org/10.1016/S0899-3467(07)60142-6
Gramajo E. The Effects of Loud NICU Environments on Premature Infants and Interventions to Help Minimize Noise. Nurs Stud Res Posters 2023. DOI: https://doi.org/10.33015/dominican.edu/2023.NURS.ST.23
Guner Basara S, Calisir H, Sahin S, Bozkurt E. Effect of Using Earmuffs on Physiological Parameters and Stress Levels of Premature Infants: A Randomised Controlled Trial. Iran J Neonatol IJN 2023; 14.
Sabagh K, Ghaljaei F, Mahmoodi N, Kerman Saravi F, Robabi H. Interventional Effect of Quiet Time Protocol on the Physiological Parameters of Premature Neonates Admitted to the Neonatal Intensive Care Unit. Med-Surg Nurs J 2023; 11: 1-8. DOI: https://doi.org/10.5812/msnj-135736
Kaur A, Kaur S, Munjal S, Ghai S, Dutta S. Effect of Earmuffs on Physiological Parameters of Preterm Neonates Nursed in Incubators: A Before-and-After Study. Indian Pediatr 2021; 58: 943-6. DOI: https://doi.org/10.1007/s13312-021-2327-y
Bazregari M, Mirlashari J, Ranjbar H, Pouraboli B. Effect of Clustered Nursing Care on Sleep Behaviors of the Preterm Neonates Admitted to the Neonatal Intensive Care Unit. Iran J Neonatol 2019; 10: 14-20.
Claire Zores-Koenig, Pierre Kuhn, Laurence Caeymaex. Recommendations on neonatal light environment from the French Neonatal Society. Acta Paediatr - Wiley Online Libr 2020; 109: 1292-301. DOI: https://doi.org/10.1111/apa.15173
Shykhveisi F, Jafarian Amiri R, Zabihi A, Haghshenas Mojaveri M, Arzani A, Chehrazi M, Chari ZV. Effect of eye shield and ear muffs on pain intensity during venous blood sampling in premature infants: a clinical trial study. BMC Pediatr 2023; 23: 161. DOI: https://doi.org/10.1186/s12887-023-03978-3
Mohammed Ali H, Abd Elmoniem Syan S, Farouk Abolwafa N. Effect of Earplugs and Eye Cover on Physiological and Behavioral Responses among Preterm Infants in Neonatal Intensive Care Unit. Int Egypt J Nurs Sci Res 2023; 3: 363-82. DOI: https://doi.org/10.21608/ejnsr.2023.277933
Sánchez-Sánchez M, García TL, Heredia D, Reséndiz I, Cruz L, Santiago J, Rojas-Granados A, Ubaldo-Reyes L, Pérez-Campos-Mayoral L, Pérez-Campos E, Vásquez GS, Moguel JM, Zarate R, García O, Sánchez L, Torres F, Paz A, Elizarraras-Rivas J, Hernández-Huerta MT, Angeles-Castellanos M. Effect of a light-darkness cycle on the body weight gain of preterm infants admitted to the neonatal intensive care unit. Sci Rep 2022; 12: 17569. DOI: https://doi.org/10.1038/s41598-022-22533-1
Beker F, Hughes IP, Jacobs S, Liley HG, Bora S, Simcock G, Davis PG. Smell and taste of milk during tube feeding of preterm infants: neurodevelopmental follow-up of the randomized TASTE trial, study protocol. Trials 2023; 24: 1-6. DOI: https://doi.org/10.1186/s13063-023-07224-0
Dawood BMAE, Elkandoz NAEl, Ads SEM, Baraka NIM. Effect of Continuous Olfactory Stimulation Using Breast Milk on Physiological Indices and Behavioral Responses of Preterm Neonates. Tanta Sci Nurs J 2024; 33: 90-8. DOI: https://doi.org/10.21608/tsnj.2024.361824
Neshat H, Jebreili M, Seyyedrasouli A, Ghojazade M, Hosseini MB, Hamishehkar H. Effects of Breast Milk and Vanilla Odors on Premature Neonate's Heart Rate and Blood Oxygen Saturation During and After Venipuncture. Pediatr Neonatol 2016; 57: 225-31. DOI: https://doi.org/10.1016/j.pedneo.2015.09.004
Arafa NM, Radwan RIM, Mohammed AAE-RA. Effect of Olfactory and Gustatory Stimulations on Preterm Neonates' Feeding Progression and Sniffing Away Feeding Tube. Egypt J Health Care 2021; 12: 1681-99. DOI: https://doi.org/10.21608/ejhc.2021.227154
Chanville ABD, Brevaut-Malaty V, Garbi A, Tosello B, Baumstarck K, Gire C, Cozannet RL. Analgesic Effect of Maternal Human Milk Odor on Premature Neonates: A Randomized Controlled Trial. J Hum Lact 2017; 33: 300-8. DOI: https://doi.org/10.1177/0890334417693225
Xiao-Li Li, Yun Liu, Miao Liu, Chun-Yan Yang, Qiao-Zhi Yang. Early Premature Infant Oral Motor Intervention Improved Oral Feeding and Prognosis by Promoting Neurodevelopment. Am J Perinatol 2020; 37: 626-32. DOI: https://doi.org/10.1055/s-0039-1685448
Ratnaningsih T, Peni T, Firdausiyah N, Wahito Nugroho HS. The analgesic effect of non-nutritive sucking on neonates during invasive procedures. Anaesth Pain Intensive Care 2024; 28: 640-5. DOI: https://doi.org/10.35975/apic.v28i4.2511
Kaya V, Aytekin A. Effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants: a randomised controlled trial. J Clin Nurs 2017; 26: 2055-63. DOI: https://doi.org/10.1111/jocn.13617
Kostandy RR, Ludington-Hoe SM. The evolution of the science of kangaroo (mother) care (skin‐to‐skin contact) -Review Article. Birth Defects Res - Wiley Online Libr 2019; 111: 1032-43. DOI: https://doi.org/10.1002/bdr2.1565
Alhoot Y, Elbanna E, Elgebaly S. The effect of kangaroo mother care in improvement of weight gain and vital signs stability in preterm and critically ill neonates. Zagazig Univ Med J 2024. DOI: https://doi.org/10.21608/zumj.2024.281675.3320
Zhu Z, Wang X, Chen W, Pei S, Wang Q, Guan H, Zhu G. The efficacy of Kangaroo-Mother care to the clinical outcomes of LBW and premature infants in the first 28 days: A meta-analysis of randomized clinical trials. Front Pediatr 2023; 11: 1067183. DOI: https://doi.org/10.3389/fped.2023.1067183
El-Farrash RA, Shinkar DM, Ragab DA, Salem RM, Saad WE, Farag AS, Salama DH, Sakr MF. Longer duration of kangaroo care improves neurobehavioral performance and feeding in preterm infants: a randomized controlled trial. Pediatr Res 2020; 87: 683-8. DOI: https://doi.org/10.1038/s41390-019-0558-6
Sen E, Manav G. Effect of Kangaroo Care and Oral Sucrose on Pain in Premature Infants: A Randomized Controlled Trial. Pain Manag Nurs 2020; 21: 556-64. DOI: https://doi.org/10.1016/j.pmn.2020.05.003
Anusha L, Radhika M. Effectiveness of Tactile Stimulation on Neurobehavioral Development and the Physiological Parameters among Neonates in NICU. Int J Health Sci Res 2022; 12: 90-7. DOI: https://doi.org/10.52403/ijhsr.20220512
Sayed AMH, Youssef MME, Hassanein FE-S, Mobarak AA. Impact of Tactile Stimulation on Neurobehavioral Development of Premature Infants in Assiut City. J Educ Pract 2015; 6: 93-102. Retrieved from https://www.iiste.org/ Journals/index.php/JEP/article/view/21014.
Khalil A, Mohammed Fathi A, Abd El Halim A. Effect of Tactile Stimulation on Neonatal Stress During Invasive Procedures at Neonatal Intensive Care Units of Port Said. Port Said Sci J Nurs 2020; 7: 1-20. DOI: https://doi.org/10.21608/pssjn.2020.123864
Fatollahzade M, Parvizi S, Kashaki M, Haghani H, Alinejad-Naeini M. The effect of gentle human touch during endotracheal suctioning on procedural pain response in preterm infant admitted to neonatal intensive care units: a randomized controlled crossover study. J Matern Fetal Neonatal Med 2020; 35: 1370-6. DOI: https://doi.org/10.1080/14767058.2020.1755649
Shamkhi HA-H, Shawq AH. Nesting Technique: The Effects on Preterm Cardiorespiratory Indicators. Kufa J Nurs Sci 2024; 14: 133-44. DOI: https://doi.org/10.36321/kjns.vi20242.16025
Nikam PN, Naregal PM, Mohite VR, Karale RB. Efficacy of Nesting on Physiological Parameters among Preterm Babies Admitted at Tertiary Care Hospital Karad. J Datta Meghe Inst Med Sci Univ 2023; 18: 181-4. DOI: https://doi.org/10.4103/jdmimsu.jdmimsu_622_22
Jeba JA, Kumar SS, Sosale S. Effect of positioning on physiological parameters on low birth weight preterm babies in neonatal intensive care unit. Int J Res Pharm Sci 2019; 10: 2801-5. DOI: https://doi.org/10.26452/ijrps.v10i4.1550
Venkatesh HA, Mohanty PK. Impact of a Short Period of Prone Versus Supine Nursing in Preterm Neonates Less Than 32 Weeks on Weight Gain: A Prospective Observational Study. J Clin Neonatol 2023; 12: 13-5. DOI: https://doi.org/10.4103/jcn.jcn_89_22
Anwar NM, Refaat NH, Mohammed FZ, Mohammed HS. Effect of Different Positions on Gastric Residual Volume of Preterm Neonates at Neonatal Intensive Care Unit. Assiut Sci Nurs J 2021; 9: 132-9. DOI: https://doi.org/10.21608/asnj.2021.88041.1216
Torabian H, Alinejad S, Bayati A, Rafiei F, Khosravi S. Comparison of the Effects of Supine and Prone Positions on Oxygen Saturation and Vital Signs in Premature Infants: A Crossover Clinical Trial. Iran J Neonatol IJN 2019; 10: 30-6.
Valizadeh L, Ghahremani G, Gharehbaghi M, Jafarabadi M. The effects of flexed (fetal tucking) and extended (free body) postures on the daily sleep quantity of hospitalized premature infants: A randomized clinical trial. J Res Med Sci 2016; 21: 124. DOI: https://doi.org/10.4103/1735-1995.196606
Downloads
Published
How to Cite
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .