Weber Ashley, Harrison Tondi M, Sinnott Loraine, Shoben Abigail, Steward Deborah
N0B040 Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio (Dr Weber); Nationwide Children's Hospital (Dr Weber); The Ohio State University College of Nursing, Columbus (Drs Harrison, Sinnott, and Steward); and The Ohio State University College of Public Health, Columbus (Dr Shoben).
Adv Neonatal Care. 2018 Feb;18(1):E12-E23. doi: 10.1097/ANC.0000000000000452.
Oxytocin (OT) is a social hormone that may help researchers understand how nurse-guided interventions during initial infant hospitalization, such as supporting human milk expression, promoting comforting touch, and reducing exposure to stressors, affect preterm brain development.
To determine whether factors related to human milk, touch, or stressor exposure are related to plasma OT trajectories in premature infants.
Plasma from 33 premature infants, born gestational ages 25 to (Equation is included in full-text article.)weeks, was collected at 14 days of life and then weekly until 34 weeks' corrected gestational age (CGA). Variables related to feeding volumes of human milk and formula; touch, as indexed by skin-to-skin contact (SSC) and swaddled holding; and clinical stressors were extracted from the electronic medical record. Linear mixed-models tested associations between nurse-guided variables and plasma OT trajectories.
In the final model, same-day SSC was positively related not only to plasma OT levels at 27 weeks' CGA (β= .938, P = .002) but also to a decline in plasma OT levels over time (β=-.177, P = .001). Volume of enteral feeds (mL/kg/d), its interaction with CGA, and number of stressful procedures were not statistically significant (β= .011, P = .077; β=-.002, P = .066; and β= .007, P = .062, respectively).
Nurse-guided interventions are associated with infant plasma OT levels, suggesting nurses may impact the neurobiology of the developing premature infant.
Replication with larger sample sizes and randomized controlled trial designs is needed to test effects of specific nursing interventions on infant OT.
催产素（OT）是一种社会激素，它可能有助于研究人员了解在婴儿初次住院期间，护士指导的干预措施，如支持母乳挤出、促进舒适的触摸以及减少应激源暴露，如何影响早产儿的大脑发育。
确定与母乳、触摸或应激源暴露相关的因素是否与早产儿的血浆OT轨迹有关。
收集了33名孕周为25至（全文包含公式）周的早产儿出生后14天的血浆，随后每周收集一次，直至矫正胎龄（CGA）达到34周。从电子病历中提取与母乳和配方奶喂养量、以皮肤接触（SSC）和襁褓包裹为指标的触摸以及临床应激源相关的变量。线性混合模型测试了护士指导变量与血浆OT轨迹之间的关联。
在最终模型中，当日的SSC不仅与矫正胎龄27周时的血浆OT水平呈正相关（β = 0.938，P = 0.002），而且与血浆OT水平随时间的下降也呈正相关（β = -0.177，P = 0.001）。肠内喂养量（mL/kg/d）、其与矫正胎龄的交互作用以及应激性操作的次数均无统计学意义（分别为β = 0.011，P = 0.077；β = -0.002，P = 0.066；β = 0.007，P = 0.062）。
护士指导的干预措施与婴儿血浆OT水平相关，这表明护士可能会影响发育中的早产儿的神经生物学。
需要采用更大样本量和随机对照试验设计进行重复研究，以测试特定护理干预措施对婴儿OT的影响。
