Skin-to-skin contact (Kangaroo Care) accelerates autonomic and neurobehavioural maturation in preterm infants
Skin-to-skin contact (Kangaroo Care) accelerates autonomic and neurobehavioural maturation in preterm infants
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DOI：
10.1017/s0012162203000525
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发表时间：
2003-04-01
影响因子：
3.8
通讯作者：
Eidelman, AI
中科院分区：
文献类型：
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作者：
Feldman, R;Eidelman, AI
对70名早产儿进行了母婴皮肤接触(袋鼠护理；KC)对自主神经功能、状态调节和神经行为状态的影响的研究，其中一半早产儿接受KC治疗24.31天(SD 7.24)，总计29.76小时(SD 12.86)。婴儿在性别(每组19名男性和16名女性)、出生体重(KC，1229.95克[SD 320.21]；对照组，1232.17克[SD 322.15])、胎龄(KC，30.28周[SD 2.54]；对照组，30.19周[SD 2.65])、医疗风险和苍蝇人口统计学方面匹配。根据KC前10分钟的心率和37周时的心率计算迷走神经张力。在出生前连续4小时内观察婴儿状态，并在37周时再次观察婴儿状态。在出生后37周用新生儿行为评定量表(NBAS)评估神经行为状态。在出生后32~37周，接受KC治疗的婴儿迷走神经张力成熟更快(P=0.029)。观察到KC婴儿的状态组织改善更快，安静睡眠(p=0.016)和警觉清醒(p=0.013)的时间更长，活动睡眠时间更短(P=0.023)。KC婴儿的神经发育特征更为成熟，尤其是习惯性(p=0.032)和定向性(p=0.007)。结果强调了早期皮肤接触在早产儿自主神经和心脏系统成熟中的作用。
The effects of mother-infant skin-to-skin contact (Kangaroo Care; KC) on autonomic functioning, state regulation, and neurobehavioural status was examined in 70 preterm infants, half of whom received KC over 24.31 days (SD 7.24) for a total of 29.76 hours (SD 12.86). Infants were matched for sex (19 males and 16 females in each group); birthweight (KC, 1229.95g [SD 320.21]; controls, 1232.17g [SD 322.15]); gestational age (GA) (KC, 30.28 weeks [SD 2.54]; controls, 30.19 weeks [SD 2.65]); medical risk; and famfly demographics. Vagal tone was calculated from 10 minutes of heart rate before KC and again at 37 weeks' GA. Infant state was observed in 10-second epochs during four consecutive hours before KC and again at 37 weeks' GA. Neurobehavioural status was assessed at 37 weeks' GA with the Neonatal Behavioral Assessment Scale (NBAS). Infants receiving KC showed a more rapid maturation of vagal tone between 32 and 37 weeks' GA (P=0.029). More rapid improvement in state organization was observed in KC infants, in terms of longer periods of quiet sleep (p=0.016) and alert wakefulness (p=0.013) and shorter periods of active sleep (P=0.023). Neurodevelopmental profile was more mature for KC infants, particularly habituation (p=0.032) and orientation (p=0.007). Results underscore the role of early skin-to-skin contact in the maturation of the autonomic and cireadian systems in preterm infants.