Sleep-Wake States and Feeding Progression in Preterm Infants.
Sleep-Wake States and Feeding Progression in Preterm Infants.
复制标题
早产儿的睡眠-觉醒状态和喂养进展。
DOI：
10.1097/nnr.0000000000000395
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发表时间：
2020
期刊：
影响因子：
2.5
通讯作者：
Brandon,DebraH
中科院分区：
文献类型：
--
作者：
Park,Jinhee;Silva,SusanG;Thoyre,SuzanneM;Brandon,DebraH
背景先前的研究表明，婴儿睡眠-觉醒状态与口腔喂养表现之间存在短期关系，状态是婴儿对喂养的神经行为准备的指示。然而，在住院期间，睡眠-觉醒状态和喂养技能之间的关系尚未进行纵向评估。目的探讨住院期间早产儿睡眠-觉醒状态发育轨迹及其与喂养进展的关系。方法：本描述性和探索性研究采用纵向两组随机对照试验的数据进行二次分析，评估早、晚周期光照对出生≤28周胎龄的极早产儿的健康和发育结局的影响。在月经后30周，每天评估两次2小时的睡眠-觉醒状态（白天和夜间），每3周评估一次，直到出院。每10秒记录一次主动睡眠、安静睡眠和清醒的次数。喂养进展是根据婴儿经后年龄在五个里程碑进行评估的：第一次肠内喂养、完全肠内喂养、第一次口服喂养、半口服喂养和完全口服喂养。轨迹分析用于描述睡眠-觉醒状态的发育变化、摄食过程模式以及摄食过程与睡眠-觉醒轨迹之间的关系。结果住院期间醒时活跃睡眠减少，静时睡眠增加。确定了两个不同的喂养组：典型和延迟喂养过程。在喂养进展延迟的婴儿中，与典型喂养进展的婴儿相比，白天活跃和安静睡眠发展的速度延迟。我们还发现，与正常喂养过程的婴儿相比，延迟喂养过程的婴儿更有可能在夜间醒来。
BackgroundPrevious studies demonstrated a short-term relationship between infant sleep–wake states and oral feeding performance, with state being an indication of infants’ neurobehavioral readiness for feeding. However, the relationship between sleep–wake states and feeding skills has not been evaluated longitudinally during hospitalization.ObjectivesThe purpose of this study was to examine preterm infants’ sleep–wake state developmental trajectories and their associations with feeding progression during hospitalization.MethodsThis descriptive and exploratory study was a secondary analysis using data from a longitudinal two-group, randomized controlled trial evaluating the effects of early and late cycled light on health and developmental outcomes among extremely preterm infants who were born≤ 28 weeks of gestational age. Sleep–wake states were assessed for two 2-hour interfeeding periods per day (day and night hours), 30 weeks postmenstrual age, and every 3 weeks until discharge. Occurrences of active sleep, quiet sleep, and waking were recorded every 10 seconds. Feeding progression was assessed based on an infant’s postmenstrual age at five milestones: first enteral feeding, full enteral feeding, first oral feeding, half oral feeding, and full oral feeding. Trajectory analyses were used to describe developmental changes in sleep–wake states, feeding progression patterns, and associations between feeding progression and sleep–wake trajectories.ResultsActive sleep decreased while waking, and quiet sleep increased during hospitalization. Two distinct feeding groups were identified: typical and delayed feeding progression. In infants with delayed feeding progression, rates of active and quiet sleep development during the day were delayed compared to those with typical feeding progression. We also found that infants with delayed feeding progression were more likely to be awake more often during the night compared to infants with typical feeding progression.