Kumar Komal, Marchman Virginia A, Morales Maya C, Scala Melissa, Travis Katherine E
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California.
Department of Psychology, Stanford University, Stanford, California.
Am J Perinatol. 2024 May;41(S 01):e1390-e1396. doi: 10.1055/a-2023-8813. Epub 2023 Jan 31.
Children born preterm, especially those born very preterm (<32 weeks of gestational age [GA]) are at risk for poor growth and adverse neurodevelopmental outcomes. Adverse growth and neurodevelopmental outcomes in preterm children have been attributed, in part, to the aversive sounds and relative speech paucity of the neonatal intensive care unit (NICU). Experimental studies that directly expose preterm infants to speech sounds in the NICU find significant improvements in health factors relevant to neurodevelopment. Few studies have examined whether natural variations in the speech environment of the NICU are related to short-term health outcomes in preterm infants. Such data are important for optimizing the sound environment of the NICU. Our objective was to examine relations between the NICU speech environment and the rate of weight gain during hospitalization.
Participants were infants born very preterm ( = 20). The speech environment of each infant was assessed at 32 to 36 weeks of postmenstrual age using an automatic speech-counting device. Average rates of weight gain (g/kg/d) were ascertained over the same period. Calories were derived from charted intake (kcals/kg/d). Linear regressions examined caloric intake and speech counts as predictors of infant weight gain.
Infant weight gain was significantly predicted by caloric intake and speech exposure, each uniquely accounting for approximately 27% variance (total = 60.2%; < 0.001). Speech counts were uncorrelated with rates of family visitation, time in incubator, or health acuity.
While future research should establish causality and direction of effects, enhancing speech exposure in the NICU may be beneficial for physical growth. NICU care plans should consider opportunities to increase speech exposure.
· Preterm infants who experienced greater amounts of speech in the NICU gained significantly more weight than preterm infants who were exposed to lower amounts of speech during the same developmental period (32-36 weeks of postmenstrual age).. · Caloric intake and speech counts accounted for almost 60% of variance in infant weight gain between 32 and 36 weeks of postmenstrual age.. · Speech counts were not significantly correlated with family visitation, how long infants resided in incubators, or health acuity.. · Findings suggest that the NICU speech environment may play an important role in the physical health of preterm infants; however, more studies are needed to determine the directionality of the observed associations..
早产出生的儿童，尤其是极早产（胎龄<32周）儿童，存在生长发育不良和神经发育不良结局的风险。早产儿童生长发育不良和神经发育不良结局部分归因于新生儿重症监护病房（NICU）中令人厌恶的声音和相对较少的言语交流。直接让早产儿接触NICU中的语音的实验研究发现，与神经发育相关的健康因素有显著改善。很少有研究探讨NICU言语环境的自然变化是否与早产儿的短期健康结局相关。此类数据对于优化NICU的声音环境很重要。我们的目的是研究NICU言语环境与住院期间体重增加率之间的关系。
参与者为极早产婴儿（=20）。在孕龄32至36周时，使用自动语音计数设备评估每个婴儿的言语环境。同期确定平均体重增加率（克/千克/天）。热量来自记录的摄入量（千卡/千克/天）。线性回归分析将热量摄入和语音计数作为婴儿体重增加的预测因素。
热量摄入和语音接触对婴儿体重增加有显著预测作用，二者各自独立解释约27%的方差（总计=60.2%；<0.001）。语音计数与家庭探视率、在暖箱中的时间或健康严重程度无关。
虽然未来的研究应确定因果关系和效应方向，但在NICU中增加语音接触可能有利于身体生长。NICU护理计划应考虑增加语音接触的机会。
· 在NICU中经历较多言语交流的早产儿比在同一发育时期（孕龄32至36周）接触较少言语交流的早产儿体重增加明显更多。· 热量摄入和语音计数占孕龄32至36周期间婴儿体重增加方差的近60%。· 语音计数与家庭探视、婴儿在暖箱中停留的时间或健康严重程度无显著相关性。· 研究结果表明，NICU言语环境可能在早产儿身体健康中起重要作用；然而，需要更多研究来确定所观察到的关联的方向性。
