Neonatal Skin-to-Skin Contact: Implications for Learning and Autonomic Nervous System Function in Infants With Congenital Heart Disease
Neonatal Skin-to-Skin Contact: Implications for Learning and Autonomic Nervous System Function in Infants With Congenital Heart Disease
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DOI：
10.1177/1099800419827599
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发表时间：
2019-05-01
影响因子：
2.5
通讯作者：
Heathcock, Jill C.
中科院分区：
文献类型：
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作者：
Harrison, Tondi M.;Chen, Chao-Ying;Heathcock, Jill C.
背景：患有复杂先天性心脏病（CCHD）的婴儿常发展为神经发育障碍。认知能力与迷走神经介导的自主神经功能有关。皮肤与皮肤接触（SSC）干预提高婴儿神经发育和自主神经功能在其他高危人群。目的：研究新生儿SSC干预对3个月大CCHD婴儿学习和自主神经功能的影响：接受新生儿SSC干预的CCHD婴儿（n = 10），典型发育（TD）婴儿（n = 16）和未接受SSC干预的CCHD婴儿（n = 10）。方法：本二次数据分析使用移动范式（MP）测量认知功能，这是一种基于操作性条件反射的经典学习测量方法。用心率（HR）和心率变异性（HRV）评估自主神经功能。本探索性研究采用重复测量一般线性混合模型，alpha = 0.10对数据进行分析。结果：TD = 75%，心脏- ssc = 70%，心脏控制= 40%。在MP期间，学习者的心率显著降低；非学习者没有表现出变化。在MP期间，TD组和心脏- ssc组表现出HR升高和HRV降低。心脏对照组无明显变化。MP期间的非线性HRV仅在TD组中有所不同。结论：研究结果表明，接受新生儿SSC治疗的3个月CCHD婴儿的认知和自主神经发育得到改善。未接受SSC治疗的CCHD婴儿的学习和自主神经功能结果表明，他们集中生理资源来完成这一认知任务的能力降低。研究结果为支持对患有CCHD的婴儿实施SSC提供了初步证据，并支持进一步的研究。
Background: Infants with complex congenital heart disease (CCHD) often develop neurodevelopmental disabilities. Cognitive abilities are associated with vagally mediated autonomic function. Skin-to-skin contact (SSC) interventions enhance infant neurodevelopment and autonomic function in other high-risk populations. Aim: To examine the effects of a neonatal SSC intervention on learning and autonomic function in 3-month-old infants: infants with CCHD who received neonatal SSC (n = 10), typically developing (TD) infants (n = 16), and infants with CCHD without SSC (n = 10). Methods: This secondary data analysis measured cognitive function using the mobile paradigm (MP), a classic measure of learning based on operant conditioning. Autonomic function was assessed with heart rate (HR) and HR variability (HRV). Data were analyzed with repeated-measures general linear mixed modeling with alpha = .10 for this exploratory study. Results: Learning rates were TD = 75%, cardiac-SSC = 70%, and cardiac-control = 40%. Learners demonstrated significant reductions in HRV during the MP; nonlearners exhibited no change. TD and cardiac-SSC groups exhibited increases in HR and reductions in HRV during the MP. No significant changes occurred in the cardiac-control group. Nonlinear HRV during the MP differed only in the TD group. Conclusions: Findings suggest improvements in cognitive and autonomic development in 3-month-old infants with CCHD who received neonatal SSC. Learning and autonomic function results in infants with CCHD who had not received SSC suggest reduced capacity to muster the physiologic resources to carry out this cognitive task. Findings provide preliminary evidence in support of implementation of SSC with infants with CCHD and support additional research.