Bushroe Kylie, Lloyd Brieann, McDaneld Chonita, Mathur Amit, Rao Rakesh
Division of Newborn Medicine, Department of Pediatrics, St. Louis Children's Hospital and Washington University in St. Louis School of Medicine, St. Louis, Missouri.
Division of Newborn Medicine, Department of Pediatrics, Cardinal Glennon Children's Hospital and St. Louis University School of Medicine, St. Louis, Missouri.
Am J Perinatol. 2024 May;41(S 01):e870-e878. doi: 10.1055/s-0042-1758726. Epub 2022 Nov 30.
Preterm infants experience daily stress in the neonatal intensive care unit (NICU). Positive sensory experiences mitigate stress responses, but parental participation can be limited by external pressures. This study aimed to describe the impact of a neonatal cuddler program (NCP) on preterm infants' growth.
A multidisciplinary program trained volunteers to interact with NICU infants when family was not at bedside. Infants were followed prospectively throughout admission. Intervention data included frequency, type, and duration of activity throughout the study period. Student -test and chi-square test were used to analyze the impact of volunteer interaction on anthropometric measures at discharge.
Forty-five infants interacted with a volunteer (intervention group, = 45) compared with the control group ( = 56) following coronavirus disease 2019 restrictions. The median (range) time of interaction with a volunteer in the intervention group was 90.0 (5.0-705.0) minutes per infant. Infants in the two groups had similar gestational ages, birth weights, lengths, and occipitofrontal circumferences (OFC). Infants in the intervention group had higher rates of spontaneous intestinal perforation, bronchopulmonary dysplasia, and reached full enteral feeds later. However, rates of severe intraventricular hemorrhage, retinopathy of prematurity, and duration of mechanical ventilation were similar. Infants in the two groups did not differ in the NICU length of stay. At discharge, infants in the intervention group weighed more ( = 0.04) and had higher OFC's ( = 0.01) and OFC -scores ( = 0.03). The change in -scores from birth to discharge was significant for the weight ( = 0.02) but not length or OFC. In regression analyses, only group allocation was identified as a significant factor for OFC -scores at discharge (= 0.279, = 0.011) and for change in weight -scores from birth to discharge ( = 0.226, = 0.041).
Growth is positively impacted by an NCP despite limited interaction. Additional work is needed to demonstrate the impact on neurobehavioral and developmental outcomes.
· Establishing and implementing a neonatal cuddler program in a large, level IV NICU is feasible.. · Neonatal cuddler programs can provide positive sensory experiences when parents are not at bedside.. · Even limited exposure to these positive sensory experiences can positively impact growth parameters for preterm infants..
早产儿在新生儿重症监护病房（NICU）每天都面临压力。积极的感官体验可减轻应激反应，但家长的参与可能会受到外部压力的限制。本研究旨在描述新生儿抱抱计划（NCP）对早产儿生长的影响。
一个多学科项目培训志愿者，以便在家人不在床边时与NICU的婴儿互动。在婴儿整个住院期间对其进行前瞻性跟踪。干预数据包括整个研究期间活动的频率、类型和持续时间。采用学生t检验和卡方检验分析志愿者互动对出院时人体测量指标的影响。
在2019年冠状病毒病限制措施实施后，45名婴儿与志愿者互动（干预组，n = 45），对照组为56名婴儿。干预组中每名婴儿与志愿者互动的中位（范围）时间为90.0（5.0 - 705.0）分钟。两组婴儿的胎龄、出生体重、身长和枕额周长（OFC）相似。干预组婴儿自发性肠穿孔、支气管肺发育不良的发生率较高，且达到完全经口喂养的时间较晚。然而，重度脑室内出血、早产儿视网膜病变的发生率及机械通气时间相似。两组婴儿在NICU的住院时间无差异。出院时，干预组婴儿体重更重（P = 0.04），OFC更大（P = 0.01），OFC评分更高（P = 0.03）。从出生到出院体重评分的变化具有显著性（P = 0.02），但身长和OFC评分无显著性变化。在回归分析中，仅分组被确定为出院时OFC评分（β = 0.279，P = 0.011）以及从出生到出院体重评分变化（β = 0.226，P = 0.041）的显著因素。
尽管互动有限，NCP对生长仍有积极影响。需要进一步开展工作以证明其对神经行为和发育结局的影响。
· 在大型四级NICU建立并实施新生儿抱抱计划是可行的。· 当家长不在床边时，新生儿抱抱计划可提供积极的感官体验。· 即使是有限地接触这些积极的感官体验也可对早产儿的生长参数产生积极影响。
