Gonya J, Feldman K, Brown K, Stein M, Keim S, Boone K, Rumpf W, Ray W, Chawla N, Butter E
Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States of America.
Interdisciplinary Center for Network Science and Applications, University of Notre Dame, Notre Dame, IN, United States of America.
Early Hum Dev. 2018 Dec;127:6-14. doi: 10.1016/j.earlhumdev.2018.08.010. Epub 2018 Sep 13.
Extremely preterm infants represent one of the highest risk categories for impairments in social competence. Few studies have explored the impact of the neonatal intensive care unit (NICU) environment on social development. However, none have specifically analyzed the effects of the care structure the infant receives during hospitalization on later social competence indicators.
To identify associations between the care structures received by extremely preterm infants in the NICU and scores on the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) post-discharge.
50 extremely preterm infants (mean gestational age: 25 weeks during hospitalization; mean chronological age during follow-up assessment: 2 years, 4 months).
A secondary analysis of BITSEA data was performed exploring its relation to care structure data we extracted from electronic medical records (i.e., how much time infants were engaged in human interaction during their first thirty days of hospitalization and what types of interaction they were exposed to).
Extremely preterm infants spend a considerable amount of time alone during hospitalization (80%) with nursing care comprising the majority of human interaction. Infants who experienced greater human interaction scored significantly higher on the Social Competence (p = 0.01) and lower on the Dysregulation (p = 0.03) BITSEA subscales.
Human interaction and isolation in the NICU is associated with social competence and dysregulation outcomes in extremely preterm infants. Further research is needed to understand how various NICU care structures including centralized nursing teams, parental skin-to-skin care, and early therapy may synergistically play a positive role in developing social competence.
极早产儿是社交能力受损风险最高的群体之一。很少有研究探讨新生儿重症监护病房（NICU）环境对社交发展的影响。然而，尚无研究专门分析婴儿住院期间所接受的护理结构对其后期社交能力指标的影响。
确定NICU中极早产儿所接受的护理结构与出院后简短婴幼儿社会和情感评估（BITSEA）得分之间的关联。
50名极早产儿（住院期间平均胎龄：25周；随访评估时的平均实际年龄：2岁4个月）。
对BITSEA数据进行二次分析，探讨其与我们从电子病历中提取的护理结构数据之间的关系（即婴儿在住院的前30天内参与人际互动的时间以及他们所接触的互动类型）。
极早产儿在住院期间大部分时间（80%）是独自度过的，护理是人际互动的主要组成部分。经历更多人际互动的婴儿在BITSEA社会能力分量表上得分显著更高（p = 0.01），在失调分量表上得分更低（p = 0.03）。
NICU中的人际互动和隔离与极早产儿的社交能力和失调结果相关。需要进一步研究以了解包括集中护理团队、父母皮肤接触护理和早期治疗在内的各种NICU护理结构如何协同发挥积极作用以培养社交能力。
