Vittner Dorothy, Butler Samantha, Smith Kelsey, Makris Nefeli, Brownell Elizabeth, Samra Haifa, McGrath Jacqueline
School of Nursing, University of Connecticut, Storrs (Drs Vittner and Ms Makris); School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, Texas (Dr. McGrath) Connecticut Children's Medical Center, Hartford (Drs Vittner and Brownell and Ms Smith); Boston Children's Hospital, Boston, Massachusetts (Dr Butler); Harvard Medical School, Harvard University, Boston, Massachusetts (Dr Butler); and School of Nursing, South Dakota State University, Brookings (Dr Samra).
Adv Neonatal Care. 2019 Feb;19(1):73-79. doi: 10.1097/ANC.0000000000000558.
Preterm infants remain increasingly neurodevelopmentally disadvantaged. Parental touch, especially during skin-to-skin contact (SSC), has potential to reduce adverse consequences.
To examine relationships between parental engagement and salivary oxytocin and cortisol levels for parents participating in SSC intervention.
A randomized crossover design study was conducted in a neonatal intensive care unit; 28 stable preterm infants, mothers, and fathers participated. Parental engagement was measured using the Parental Risk Evaluation Engagement Model Instrument (PREEMI) prior to hospital discharge. Saliva samples for oxytocin and cortisol levels were collected 15-minute pre-SSC, 60-minute during-SSC, and 45-minute post-SSC.
Data were analyzed using Pearson's correlation to measure relationships between parental engagement composite scores and salivary oxytocin and cortisol levels. A significant negative correlation between paternal engagement and paternal oxytocin levels (r = -0.43; P = .03) and a significant negative correlation between infant oxytocin levels and maternal engagement (r = -0.54; P = .004) were present. Adjusted linear regression models demonstrated that as infant oxytocin levels increased during SSC, maternal engagement scores significantly decreased at discharge (β = -.04; P = .01). Linear regression, adjusting for infant oxytocin and cortisol levels, showed that as paternal oxytocin levels increased, there was a significant decrease in paternal engagement (β = -.16; P = .03) and as paternal cortisol levels increased, there was a significant decrease in paternal engagement (β = -68.97; P =.05).
Significant relationships exist between parental engagement and salivary oxytocin and cortisol levels. Defining parent engagement facilitates identification of parent risks and needs for intervention to optimize preterm outcomes.
The PREEMI can serve as a standardized instrument to examine parent engagement.
早产儿在神经发育方面仍然越来越处于劣势。父母的抚摸，尤其是在皮肤接触（SSC）期间，有可能减少不良后果。
研究参与SSC干预的父母的亲子互动与唾液中催产素和皮质醇水平之间的关系。
在新生儿重症监护病房进行了一项随机交叉设计研究；28名病情稳定的早产儿、母亲和父亲参与了研究。在出院前使用父母风险评估参与模型工具（PREEMI）测量亲子互动情况。在SSC前15分钟、SSC期间60分钟和SSC后45分钟收集唾液样本以检测催产素和皮质醇水平。
使用Pearson相关性分析数据，以测量亲子互动综合得分与唾液中催产素和皮质醇水平之间的关系。父亲的参与度与父亲的催产素水平之间存在显著负相关（r = -0.43；P = 0.03），婴儿的催产素水平与母亲的参与度之间存在显著负相关（r = -0.54；P = 0.004）。调整后的线性回归模型表明，在SSC期间婴儿催产素水平升高时，母亲在出院时的参与度得分显著降低（β = -0.04；P = 0.01）。在调整了婴儿催产素和皮质醇水平的线性回归分析中，结果显示随着父亲催产素水平的升高，父亲的参与度显著降低（β = -0.16；P = 0.03），并且随着父亲皮质醇水平的升高，父亲的参与度也显著降低（β = -68.97；P = 0.05）。
亲子互动与唾液中催产素和皮质醇水平之间存在显著关系。明确父母的参与情况有助于识别父母的风险以及优化早产结局所需的干预需求。
PREEMI可作为一种标准化工具来研究父母的参与情况。
