Experimentalist Assistant, School of Nursing, Fujian Medical University, Fuzhou, China.
Research Assistant, School of Nursing, Fujian Medical University, Fuzhou, China.
Int J Nurs Stud. 2021 Jul;119:103934. doi: 10.1016/j.ijnurstu.2021.103934. Epub 2021 Mar 26.
A few positive effects of mothers' voice on physiological outcomes have been studied and limited studies have focused on the level of cortisol. In addition, white noise has recently been found to be beneficial for human sleep, but studies in premature infants were limited and no study has compared the effects of mothers' voice and white noise on premature infants.
To examine the effects of mothers' voice and white noise on sleep-wake patterns, salivary cortisol levels, weight gain, heart rate, and oxygen saturation of premature infants in a neonatal intensive care unit (NICU).
This was a three-group randomized controlled trial. A total of 103 medically stable premature infants in incubators were recruited from the NICU of a women's and children's hospital in China between March and December 2017 and were randomized into three groups: the mothers' voice group (n = 34), the white noise group (n = 34), and the routine care group (n = 35). Mothers' voice, white noise, and no voice were provided to the three groups for 20 min at a time, three times a day for four consecutive days. The sound levels of the mothers' voice and white noise were controlled between 50 and 55 dB. Sleep-wake patterns, salivary cortisol level, and weight were measured at pre-test and post-test whereas heart rate and oxygen saturation were measured every five-minute at 11am, 2pm, 5pm for four-consecutive days.
A group difference was found only in weight gain (p = 0.003), with weight gain in the white noise group being significantly higher than the mothers' voice group (Z=-3.447, p = 0.001). Significant declines in total sleep time and sleep efficiency and increases in wake time after sleep onset and average awakening time were only found in the routine-care group between the pre-test and post-test (p<0.05). No significant differences were found in the salivary cortisol levels, heart rates, and oxygen saturation levels among the three groups (p>0.05). A significant increase in oxygen saturation during the 20-min intervention was found in white noise group. Non-significant decreases in the heart rate during the 20-min intervention and salivary cortisol levels at post test were noted in all the three groups.
White noise is more useful for encouraging weight gain in preterm infants compared with mothers' voices. White noise might be introduced for use in the care of premature infants in NICUs, and more high-quality randomized controlled trials are needed to confirm these findings. Trial Registration No: ChiCTR-INR-17012755.
已有研究表明母亲的声音对生理结果有一些积极影响，而有限的研究则集中在皮质醇水平上。此外，白噪声最近被发现对人类睡眠有益，但早产儿的研究有限，没有研究比较母亲的声音和白噪声对早产儿的影响。
探讨母亲的声音和白噪声对新生儿重症监护病房（NICU）中早产儿睡眠-觉醒模式、唾液皮质醇水平、体重增加、心率和血氧饱和度的影响。
这是一项三臂随机对照试验。2017 年 3 月至 12 月，在中国一家妇女儿童医院的 NICU 中，共招募了 103 名医学稳定的早产儿，并将其随机分为三组：母亲声音组（n=34）、白噪声组（n=34）和常规护理组（n=35）。三组均在 20 分钟内给予母亲的声音、白噪声和无声音，每天三次，连续四天。母亲的声音和白噪声的声级控制在 50 至 55dB 之间。在预测试和后测试时测量睡眠-觉醒模式、唾液皮质醇水平和体重，而在连续四天的每天 11 点、2 点和 5 点每 5 分钟测量心率和血氧饱和度。
仅在体重增加方面发现了组间差异（p=0.003），白噪声组的体重增加明显高于母亲声音组（Z=-3.447，p=0.001）。仅在常规护理组中，在预测试和后测试之间发现总睡眠时间和睡眠效率显著下降，睡眠后觉醒时间和平均觉醒时间增加（p<0.05）。三组间唾液皮质醇水平、心率和血氧饱和度无显著差异（p>0.05）。在白噪声组中，20 分钟干预期间的血氧饱和度显著升高。所有三组在 20 分钟干预期间的心率均无显著下降，且在测试后唾液皮质醇水平均无显著下降。
与母亲的声音相比，白噪声更有助于促进早产儿体重增加。白噪声可引入早产儿 NICU 护理中，需要更多高质量的随机对照试验来证实这些发现。
ChiCTR-INR-17012755。
