Marquette University, College of Nursing, Milwaukee, Wisconsin (Dr Malin); Children's Wisconsin, Milwaukee (Drs Malin and White-Traut); Medical College of Wisconsin, Milwaukee (Ms Kruschel and Dr Lagatta); University of Washington, The Department of Child, Family, and Population Health Nursing, Seattle, Washington (Dr Gondwe); The Kinsey Institute at Indiana University, Bloomington, Indiana (Drs Carter and Nazarloo); and University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania (Dr Conley).
Adv Neonatal Care. 2023 Dec 1;23(6):583-595. doi: 10.1097/ANC.0000000000001112. Epub 2023 Nov 9.
Stress from preterm infant admission to the neonatal intensive care unit (NICU) is associated with infant and maternal physiologic changes, including endocrine and epigenetic alterations. Little is known about the mechanisms connecting NICU stress to biologic changes, and whether preterm infant and maternal stress are reciprocal. As a preliminary step, feasibility and acceptability of measuring indicators of stress are required.
This study evaluated the feasibility and acceptability of research examining perceptions and biologic markers of stress in premature infant-maternal dyads during and after NICU hospitalization.
We evaluated study feasibility using a longitudinal descriptive design. Acceptability was measured via a maternal questionnaire. Exploratory data regarding hospitalization, perceptions of stress, social support and social determinants of health, and biologic markers of stress were collected during the first week of life and again 3 months after NICU.
Forty-eight mothers were eligible for the study, 36 mothers were approached, 20 mothers consented to participate, and 14 mothers completed data collection. Mothers reported high levels of study acceptability despite also voicing concern about the sharing of genetic data. Exploration of DNA methylation of SLC6A4 in preterm infants was significant for a strong correlation with perception of total chronic stress.
Clinical practice at the bedside in the NICU should include standardized screening for and early interventions to minimize stress. Complex research of stress is feasible and acceptable. Future research should focus on linking early life stress with epigenetic alterations and evaluation of the dyad for reciprocity.
早产儿入住新生儿重症监护病房（NICU）所带来的压力会导致婴儿和产妇的生理变化，包括内分泌和表观遗传改变。目前对于将 NICU 压力与生物学变化联系起来的机制知之甚少，也不清楚早产儿和产妇的压力是否相互影响。作为初步步骤，需要评估测量压力指标的可行性和可接受性。
本研究评估了在 NICU 住院期间和出院后研究早产儿-产妇对压力的认知和生物标志物的可行性和可接受性。
我们采用纵向描述性设计评估研究的可行性。通过产妇问卷来衡量可接受性。在生命的第一周和 NICU 出院后 3 个月，收集有关住院、压力认知、社会支持和健康的社会决定因素以及压力的生物标志物的探索性数据。
48 位母亲符合研究条件，其中 36 位母亲被邀请参加，20 位母亲同意参加，14 位母亲完成了数据收集。尽管母亲们对共享遗传数据表示担忧，但仍报告了较高的研究可接受性。对早产儿 SLC6A4 的 DNA 甲基化的探索性分析表明，其与感知的总慢性压力之间存在很强的相关性。
NICU 床边的临床实践应包括标准化的压力筛查和早期干预，以尽量减少压力。对压力的复杂研究是可行且可接受的。未来的研究应侧重于将早期生活压力与表观遗传改变联系起来，并评估对相互关系的影响。
