1289 Effect of Positioning and Environmental Stressors on Physiological Stress of Preterm Infants

Abstract

Aims: The purpose of the study was to examine the effects of prone and supine sleeping positions and stressors in the acute care environment on physiological indicators of stress and sleep-wake states of preterm infants. Methods: A quasi-experimental, repeatedmeasures research design was used. Twenty-two preterm infants in an intermediate baby care unit at a medical center in Taiwan were enrolled in the study. Each infant was alternately placed in the supine or prone sleep position for an hour each time. Measurements of sleep-wake states and physiological indicators of stress were taken every two minutes during the observation period. Results: A total of 2410 observations were accrued. In the prone position, preterm infants had a significantly higher level of oxygen saturation than in the supine position (p=0.0002). Moreover, preterm infants demonstrated significantly more frequent and longer sleep states in the prone position (p <.0001). Interventions with infant handling by nurses resulted in 10 times more episodes of waking states, 5 times greater stress levels as measured by heart rate and 7 times more episodes of oxygen saturation falling below 90% than other environmental interventions for preterm infants. Conclusion: These results suggest that the prone position might be the best position for facilitating sleep and reducing stress for preterm infants. Providing an environment that controls noise and light and decreases infant handling may best support the infant's emerging organization, and foster growth and development.