Nutritive sucking and neurobehavioral development in preterm infants from 34 weeks PCA to term.
Nutritive sucking and neurobehavioral development in preterm infants from 34 weeks PCA to term.
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DOI：
10.1097/00005721-200003000-00004
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发表时间：
2000-03-01
期刊：
影响因子：
--
通讯作者：
Bilker, W
中科院分区：
文献类型：
--
作者：
Medoff-Cooper, B;McGrath, J M;Bilker, W
目的：调查早产儿从孕后 34 周到足月的营养吸吮模式、行为状态和神经行为发育的变化。设计：采用非实验描述性相关设计。方法：方便样本包括 66 名出生时胎龄在 24 至 34 周之间的早产儿。平均孕龄为 29.7 周，平均出生体重为 1379 克。仪器包括 Kron 营养吸吮仪、Anderson 行为状态量表 (ABSS) 和 Brazelton 新生儿行为评估量表 (BNBAS)。在 PCA 34 周和 40 周时进行喂养程序，在 PCA 40 周时进行 BNBAS。数据分析策略包括 t 检验、Spearman rho 相关性、Wilcoxon 配对符号秩检验和随机系数模型。 结果：34 个吸吮次数 (p < 0.001)、吸吮压力强度 (p < 0.001)、吸吮平均时间 (p < 0.001) 和爆发之间平均时间 (p < 0.001) 存在显着差异。周 PCA 至足月。随着成熟，早产儿从 34 周到足月的吸吮过程中明显更加警觉（p < 0.001）。然而，34 周 PCA 和足月时的婴儿吸吮参数与 BNBAS 或婴儿状态没有显着相关。 临床意义：这些结果表明，从 34 周 PCA 到足月，高风险早产儿的吸吮行为和保持更警觉的行为状态的能力显着成熟。然而，与足月婴儿不同的是，足月婴儿的状态与喂养（吸吮）成功呈正相关，早产儿的警觉状态可能不会增强 34 周 PCA 时的吸吮技能。这些婴儿可能压力太大，无法管理喂养和来自环境的刺激，而在警觉时这是不可避免的。然而，这种关系似乎在 40 周 PCA 后发生了变化。
PURPOSE: To investigate changes in nutritive sucking patterns, behavioral state, and neurobehavioral development of preterm infants from the 34 weeks postconceptional age (PCA) to term.DESIGN: Nonexperimental descriptive correlational design was used.METHODS: A convenience sample included 66 preterm infants with a gestational age between 24 and 34 weeks at birth. Mean gestational age was 29.7 weeks, with a mean birthweight of 1379 grams. Instruments included the Kron Nutritive Sucking Apparatus, the Anderson Behavioral State Scale (ABSS), and the Brazelton Neonatal Behavioral Assessment Scale (BNBAS). A feeding procedure was administered at 34 and 40 weeks PCA with BNBAS administered at 40 weeks PCA. Data analysis strategies included t-tests, Spearman rho correlations, Wilcoxon matched-pairs signed-ranks test, and a Random Coefficients Model.RESULTS: There were significant differences in number of sucks (p < 0.001), intensity of sucking pressures (p < 0.001), average time between sucks (p < 0.001), and average time between bursts (p < 0.001) from 34 weeks PCA to term. With maturation, it was noted that the preterm infants were significantly more alert during the sucking protocol from 34 weeks to term (p < 0.001). Yet, infant sucking parameters at 34 weeks PCA and term were not significantly related to the BNBAS or to the infant's state.CLINICAL IMPLICATIONS: These results demonstrate that high risk preterm infants mature significantly in their sucking behaviors and in their ability to maintain a more alert behavioral state from 34 weeks PCA to term. However, unlike full term infants--where state is positively correlated to feeding (sucking) success--the preterm infant state of alertness may not enhance sucking skills at 34 weeks PCA. These infants may be too stressed to manage both feeding and stimulation from the environment that is unavoidable when alert. However, this relationship does appear to change by 40 weeks PCA.