Lazarus Molly F, Marchman Virginia A, Brignoni-Pérez Edith, Dubner Sarah, Feldman Heidi M, Scala Melissa, Travis Katherine E
medRxiv. 2024 Apr 8:2023.04.06.23288260. doi: 10.1101/2023.04.06.23288260.
Limited research links hospital-based experiences of skin-to-skin (STS) care to longer-term neurodevelopmental outcomes in preterm children. The present study examined relations between inpatient STS and neurodevelopmental scores measured at 12 months in a sample of very preterm (VPT) infants.
From a retrospective study review of medical records of 181 VPT infants (<32 weeks gestational age (GA)) we derived the STS rate, i.e., the total minutes of STS each infant received/day of hospital stay. We used scores on the Capute Scales from routine follow-up care at 12 months as the measure of neurodevelopmental outcome (n=181).
Families averaged approximately 17 minutes/day of STS care (2 days/week, 70 minutes/session), although there was substantial variability. Variation in STS rate was positively associated with outcomes at 12 months corrected age ( = 0.25, .001). STS rate significantly predicted 6.2% unique variance in 12-month neurodevelopmental outcomes, after controlling for GA, socioeconomic status (SES), health acuity, and visitation frequency. A 20-minute increase in STS per day was associated with a 10-point increase (.67 SDs) in neurodevelopmental outcomes at 12 months. SES, GA, and infant health acuity did not moderate these relations.
VPT infants who experienced more STS during hospitalization demonstrated higher scores on 12-month assessments of neurodevelopment. Results provide evidence that STS care may confer extended neuroprotection on VPT infants through the first year of life.
将基于医院的皮肤接触(STS)护理体验与早产儿的长期神经发育结局联系起来的研究有限。本研究调查了极早产儿(VPT)样本中住院期间的STS与12个月时测量的神经发育评分之间的关系。
通过对181例VPT婴儿(胎龄<32周(GA))的病历进行回顾性研究,我们得出了STS率,即每个婴儿住院期间每天接受的STS总时长。我们将12个月常规随访护理时的卡普特量表评分用作神经发育结局的衡量指标(n = 181)。
家庭平均每天接受约17分钟的STS护理(每周2天,每次70分钟),尽管存在很大差异。STS率的变化与矫正年龄12个月时的结局呈正相关(r = 0.25,P <.001)。在控制了GA、社会经济地位(SES)、健康严重程度和探视频率后,STS率显著预测了12个月神经发育结局中6.2%的独特方差。每天STS增加20分钟与12个月时神经发育结局增加10分(0.67个标准差)相关。SES、GA和婴儿健康严重程度并未调节这些关系。
住院期间接受更多STS的VPT婴儿在12个月神经发育评估中的得分更高。结果提供了证据表明,STS护理可能在生命的第一年为VPT婴儿提供延长的神经保护。