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皮肤接触式住院护理可预测极早产儿 12 个月神经发育结局。

Inpatient Skin-to-skin Care Predicts 12-Month Neurodevelopmental Outcomes in Very Preterm Infants.

机构信息

Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA; Department of Pediatrics, Burke-Cornell Medical Research Institute, Weill Medical College, Cornell University, New York, NY.

Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA; Department of Psychology, Stanford University, Stanford, CA.

出版信息

J Pediatr. 2024 Nov;274:114190. doi: 10.1016/j.jpeds.2024.114190. Epub 2024 Jul 14.

Abstract

OBJECTIVE

To examine the relationship between inpatient skin-to-skin care rates and neurodevelopmental scores measured at 12 months in very preterm (VPT) infants.

STUDY DESIGN

From a retrospective review of medical records of 181 VPT infants (<32 weeks gestational age [GA] at birth), we derived skin-to-skin care rate, ie, total minutes of skin-to-skin care each infant received over the number of days of hospital stay. We used scores on the Capute Scales from routine follow-up assessments at 12 months to measure neurodevelopmental outcomes.

RESULTS

Families averaged approximately 17 minutes/day of skin-to-skin care (2 days/week, 70 minutes/session), although there was substantial variability. Variation in skin-to-skin rate was positively associated with outcomes at 12 months corrected age (r = 0.25, P < .001). Skin-to-skin rate significantly predicted 6.2% unique variance in 12-month neurodevelopmental outcomes, after adjusting for GA, socioeconomic status (SES), health acuity, and visitation frequency. A 20-minute increase in skin-to-skin care per day was associated with a 10-point increase (0.67 SDs) in neurodevelopmental outcomes at 12 months. GA and infant health acuity did not moderate these relations.

CONCLUSION

VPT infants who experienced more skin-to-skin care during hospitalization demonstrated higher scores on 12-month neurodevelopmental assessments. Results provide evidence that skin-to-skin care confers extended benefits to VPT infants through the first year of life. Skin-to-skin care offers promise as a family-centered intervention designed to promote positive developmental outcomes in at-risk infants.

摘要

目的

探讨极低出生体重儿(VPT)住院期间皮肤接触护理率与 12 个月时神经发育评分之间的关系。

研究设计

本研究回顾性分析了 181 例 VPT 婴儿(出生时胎龄[GA]<32 周)的病历,得出皮肤接触护理率,即每个婴儿在住院天数内接受的皮肤接触护理总分钟数。我们使用 12 个月时常规随访评估的 Capute 量表评分来衡量神经发育结果。

结果

家庭平均每天进行约 17 分钟的皮肤接触护理(每周 2 天,每次 70 分钟),尽管存在较大差异。皮肤接触率的变化与 12 个月校正年龄时的结果呈正相关(r=0.25,P<0.001)。在调整了 GA、社会经济状况(SES)、健康严重程度和探视频率后,皮肤接触率显著预测了 12 个月神经发育结果的 6.2%独特方差。每天增加 20 分钟的皮肤接触护理与 12 个月时神经发育结果增加 10 分(0.67 SD)相关。GA 和婴儿健康严重程度并不能调节这些关系。

结论

在住院期间接受更多皮肤接触护理的 VPT 婴儿在 12 个月时神经发育评估中得分更高。结果表明,皮肤接触护理通过生命的第一年为 VPT 婴儿提供了扩展的益处。皮肤接触护理有望成为一种以家庭为中心的干预措施,旨在促进高危婴儿的积极发育结果。

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