Bertelle Valerie, Mabin Dominique, Adrien Joelle, Sizun Jacques
Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, 29609 Brest, France.
Early Hum Dev. 2005 Jul;81(7):595-600. doi: 10.1016/j.earlhumdev.2005.01.008. Epub 2005 Mar 16.
Sleep is the main behavioral state of the premature infant. In adult intensive care units, sleep deprivation has been reported as one of the major stressors. Developmental care (DC) aims to decrease stressful events in neonatal intensive care unit and support well-being.
To assess whether DC is accompanied by changes in sleep in preterm neonates.
A prospective cross-over study included 33 preterm neonates [mean (S.D.): gestational age: 29.3 (1.8) weeks; birth weight: 1245 (336) g]. Polysomnography was performed in two randomly ordered 3-h periods with and without DC. A blinded electrophysiologist analyzed sleep. The total sleep time (TST) was the primary outcome, duration of active (AS), quiet (QS) and indeterminate sleep, and latency before sleep were the secondary outcomes. Non-parametric Wilcoxon tests and ANOVA were used.
In DC condition vs. control: TST increased [in minutes, mean (S.E.M.): 156.2 (2.9) vs. 139.2 (4.6), p=0.002], with increase in AS [86.6 (3.7) vs. 77.0 (4.2), p=0.024] and in QS [47.1 (4.1) vs. 36.9 (4.2), p=0.015], and sleeping latency decreased (2.1 (0.7) vs. 10.5 (2.0), p=0.0005].
DC promoted sleep in our study. The impact of DC on the neuro-behavioral outcome needs futures studies.
睡眠是早产儿的主要行为状态。在成人重症监护病房，睡眠剥夺已被报道为主要应激源之一。发育照护（DC）旨在减少新生儿重症监护病房中的应激事件并促进健康。
评估发育照护是否会伴随早产儿睡眠的变化。
一项前瞻性交叉研究纳入了33例早产儿[平均（标准差）：胎龄：29.3（1.8）周；出生体重：1245（336）克]。在有和没有发育照护的两个随机安排的3小时时间段内进行多导睡眠图监测。由一位不知情的电生理学家分析睡眠情况。总睡眠时间（TST）是主要结局指标，活跃睡眠（AS）、安静睡眠（QS）和不确定睡眠的持续时间以及睡眠潜伏期是次要结局指标。使用非参数威尔科克森检验和方差分析。
与对照相比，在发育照护情况下：总睡眠时间增加[以分钟计，平均（标准误）：156.2（2.9）对139.2（4.6），p = 0.002]，活跃睡眠增加[86.6（3.7）对77.0（4.2），p = 0.024]，安静睡眠增加[47.1（4.1）对36.9（4.2），p = 0.015]，睡眠潜伏期缩短（2.1（0.7）对10.5（2.0），p = 0.0005]。
在我们的研究中，发育照护促进了睡眠。发育照护对神经行为结局的影响需要未来进一步研究。
