Department of Occupational Therapy, School of Allied Health, Medical Faculty, Tel Aviv University, Israel.
Infant Behav Dev. 2011 Apr;34(2):257-63. doi: 10.1016/j.infbeh.2010.12.014. Epub 2011 Mar 9.
The purpose of the study is to assess the influence of prone or supine position on sleep states and on withdrawal and approach reactions of preterm infants.
Thirty-two preterm infants from Meir Medical Center, Israel, mean post menstrual age 30.37±2.57, mean birth weight 1250g±313.86, participated in the study. Infants were studied during 48h. Positions (prone and supine) were alternated every 3-4h after feedings. Sleep states were assessed by Actigraph measurement and by two daily 30-min Naturalistic Observations of Newborn Behavior (NONB) to confirm sleep states and for recording the behavioral reactions (approach and withdrawal).
In the prone position there were more approach reactions as compared to withdrawal reactions (p<.001) while in the supine position, the approach and withdrawal reactions were comparable. In the prone position more sleep patterns (deep sleep, light sleep, drowsy) were observed as opposed to more awake patterns (quiet awake, active awake and agitated fussy) that were seen in the supine position.
Clinical implications encourage placing the preterm infant in the prone position while in the NICU. This enables important achievements such as longer periods of quality sleep, and production of adaptive self-regulatory reactions.
本研究旨在评估早产儿取俯卧位或仰卧位对其睡眠状态及撤退和趋近反应的影响。
本研究纳入了来自以色列迈尔医疗中心的 32 名早产儿，平均胎龄 30.37±2.57 周，平均出生体重 1250g±313.86g。在 48 小时内对婴儿进行研究，在每次喂食后 3-4 小时更换体位（俯卧位和仰卧位）。通过 Actigraph 测量和每日 2 次 30 分钟的新生儿自然行为观察（NONB）评估睡眠状态，并记录行为反应（趋近和撤退）。
在俯卧位时，趋近反应多于撤退反应（p<.001），而在仰卧位时，趋近和撤退反应相似。在俯卧位时，观察到更多的睡眠模式（深睡、浅睡、昏昏欲睡），而在仰卧位时，观察到更多的清醒模式（安静清醒、活跃清醒和烦躁不安）。
临床意义鼓励在新生儿重症监护病房中让早产儿取俯卧位。这使得他们能够获得重要的成就，如更长时间的优质睡眠，并产生适应性的自我调节反应。
