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袋鼠式护理对调节早产儿及其母亲慢性应激反应的影响。

The effect of kangaroo care on modulate chronic stress response in preterm infants and mothers.

作者信息

Souza-Vogler Sandra Regina de, Lima Geisy Maria de Souza

机构信息

School of Nursing, University of Sao Paulo at Ribeirao Preto, Ribeirao Preto, Brazil.

Institute of Integral Medicine Professor Fernando Figueira (IMIP), Department of Neonatology, Recife, Brazil.

出版信息

Stress. 2021 Nov;24(6):742-752. doi: 10.1080/10253890.2021.1900107. Epub 2021 Apr 10.

DOI:10.1080/10253890.2021.1900107
PMID:33843436
Abstract

To assess stress experienced during Neonatal Intensive Care Unit (NICU) stay, we analyzed fingernail Cortisol (CORT) and Dehydroepiandrosterone (DHEA) levels and ratios in mothers and preterm infants (PI); compared hormones levels/ratio (CORT and DHEA) in kangaroo care (KC) versus standard care (SC) groups and examined relationships between PI hormone levels total days spent in the NICU. Mothers and their infants were recruited in the NICU, included levels I-IV and kangaroo care unit, within one week of infant birth in hospitals in Brazil. At 3 months after birth, mothers provided 3-month growth clippings from all ten digits of their own and their infants' fingernails. CORT and DHEA were measured using enzyme immunoassays (mothers) and high-performance-liquid-chromatography-with-mass-spectrometry (infants). Sample:  = 59 mothers (KC = 30/SC = 29) and 63 infants (KC = 32/SC = 31). Data were analyzed using non-parametric/parametric comparative statistics. NICU stay ranged from 3-103 days. For mothers in Kangaroo and Standard Care the CORT, DHEA levels and DHEA:CORT ratio (DC) ratio did not differ. Infants in KC had higher DHEA ( = 0.003) and a higher DC ratio ( = 0.011) than SC infants. Even though KC infants stayed in the NICU for a greater number of days than infants in SC, they had higher mean level of DHEA, and DC ratio, suggesting that KC played a role in promoting their stress regulatory capacities and may mitigate toxic effects of chronic hypercortisolemia. However, for mothers, KC did not reduce chronic stress compared to that in women in the SC condition. Further research warranted.

摘要

为评估新生儿重症监护病房(NICU)住院期间所经历的压力,我们分析了母亲和早产儿(PI)指甲中的皮质醇(CORT)和脱氢表雄酮(DHEA)水平及比率;比较了袋鼠式护理(KC)组和标准护理(SC)组的激素水平/比率(CORT和DHEA),并研究了PI激素水平与在NICU住院总天数之间的关系。母亲及其婴儿在巴西医院婴儿出生后一周内被招募进入NICU,包括I-IV级病房和袋鼠式护理病房。出生3个月后,母亲提供自己和婴儿所有十根手指的3个月生长指甲剪。使用酶免疫分析法(母亲)和高效液相色谱-质谱联用仪(婴儿)测量CORT和DHEA。样本:59名母亲(KC组=30名/SC组=29名)和63名婴儿(KC组=32名/SC组=31名)。数据采用非参数/参数比较统计分析。NICU住院时间为3至103天。袋鼠式护理组和标准护理组的母亲,其CORT、DHEA水平及DHEA:CORT比率(DC比率)没有差异。KC组婴儿的DHEA水平(P=0.003)和DC比率(P=0.011)高于SC组婴儿。尽管KC组婴儿在NICU的住院天数比SC组婴儿多,但他们的DHEA平均水平和DC比率更高,这表明KC在促进他们的压力调节能力方面发挥了作用,可能减轻慢性高皮质醇血症的毒性作用。然而,对于母亲来说,与SC组的女性相比,KC并没有减轻慢性压力。需要进一步研究。

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