Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA.
J Perinatol. 2013 Aug;33(8):636-41. doi: 10.1038/jp.2013.4. Epub 2013 Feb 14.
To investigate the effects of parental presence and infant holding in the neonatal intensive care unit (NICU) on neurobehavior at term equivalent.
Prospective cohort enrolled 81 infants born 30 weeks gestation. Nurses tracked parent visitation, holding and skin-to-skin care throughout the NICU hospitalization. At term, the NICU Network Neurobehavioral Scale was administered. Associations between visitation, holding and early neurobehavior were determined using linear and logistic regression.
The mean hours per week of parent visitation was 21.33±20.88 (median=13.90; interquartile range 10.10 to 23.60). Infants were held an average of 2.29±1.47 days per week (median=2.00; interquartile range 1.20 to 3.10). Over the hospital stay, visitation hours decreased (P=0.01), while holding frequencies increased (P<0.001). More visitation was associated with better quality of movement (P=0.02), less arousal (P=0.01), less excitability (P=0.03), more lethargy (P=0.01) and more hypotonia (P<0.01). More holding was associated with improved quality of movement (P<0.01), less stress (P<0.01), less arousal (P=0.04) and less excitability (P<0.01).
Infants of caregivers who were visited and held more often in the NICU had differences in early neurobehavior by term equivalent, which supports the need for and importance of early parenting in the NICU.
研究新生儿重症监护病房（NICU）中父母的存在和婴儿的怀抱对足月时神经行为的影响。
前瞻性队列纳入了 81 名胎龄＜30 周的婴儿。护士在整个 NICU 住院期间跟踪父母探视、怀抱和皮肤接触情况。在足月时，进行 NICU 网络神经行为量表评估。使用线性和逻辑回归确定探视、怀抱与早期神经行为之间的关联。
每周父母探视的平均时间为 21.33±20.88 小时（中位数=13.90；四分位距 10.10 至 23.60）。婴儿平均每周被怀抱 2.29±1.47 天（中位数=2.00；四分位距 1.20 至 3.10）。在住院期间，探视时间减少（P=0.01），而怀抱频率增加（P＜0.001）。更多的探视与更好的运动质量相关（P=0.02），更少的觉醒（P=0.01），更少的兴奋（P=0.03），更多的昏睡（P=0.01）和更多的低张力（P＜0.01）。更多的怀抱与改善的运动质量相关（P＜0.01），更少的应激（P＜0.01），更少的觉醒（P=0.04）和更少的兴奋（P＜0.01）。
在 NICU 中经常接受探视和怀抱的婴儿在足月时的早期神经行为存在差异，这支持了在 NICU 中早期父母参与的必要性和重要性。
