Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Pediatr Res. 2020 Mar;87(4):683-688. doi: 10.1038/s41390-019-0558-6. Epub 2019 Sep 7.
To investigate the effect of kangaroo care (KC) and its duration on neurobehavioral performance, stress response, breastfeeding success, and vital signs in premature infants.
One hundred and twenty premature infants were randomized to receive either KC for 60 min daily, KC for 120 min daily or conventional care (controls) for at least 7 days. Salivary cortisol was measured before and after the first KC session and then after 7 days. Temperature, respiration rate, heart rate, and oxygen saturation were recorded, before and after KC. Neonates were evaluated by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS).
Both KC groups demonstrated higher scores for attention, arousal, regulation, nonoptimal reflexes, and quality of movements and lower scores for handling, excitability, and lethargy, compared to controls (p < 0.05). Both KC groups had higher infant breastfeeding assessment tool score and reached full enteral feeds faster than controls (p < 0.05). After the first KC session, improvement in O saturation and temperature was observed in KC 120-min group compared with the KC 60-min group (p < 0.05). Salivary cortisol decreased in both KC groups compared with controls after 7 days (p < 0.05).
Preterm neonates who receive KC for long durations reach full enteral feeds faster, have better breastfeeding success, neurobehavioral performance, thermal control, and tissue oxygenation.
研究袋鼠护理（KC）及其持续时间对早产儿神经行为表现、应激反应、母乳喂养成功率和生命体征的影响。
将 120 例早产儿随机分为每天接受 60 分钟 KC、每天接受 120 分钟 KC 或至少接受 7 天常规护理（对照组）。在第一次 KC 治疗前后测量唾液皮质醇，然后在第 7 天测量。记录 KC 前后的体温、呼吸频率、心率和氧饱和度。使用新生儿重症监护病房网络神经行为评分量表（NNNS）对新生儿进行评估。
与对照组相比，两组 KC 组的注意力、觉醒、调节、非最佳反射和运动质量评分均较高，而处理、兴奋和嗜睡评分较低（p<0.05）。两组 KC 组的婴儿母乳喂养评估工具评分均较高，且达到全肠内喂养的速度均快于对照组（p<0.05）。与 KC 60 分钟组相比，KC 120 分钟组在第一次 KC 治疗后，氧饱和度和体温的改善更为明显（p<0.05）。与对照组相比，两组 KC 组在第 7 天后唾液皮质醇均降低（p<0.05）。
接受长时间 KC 的早产儿更快地达到全肠内喂养，母乳喂养成功率更高，神经行为表现、体温控制和组织氧合更好。
