Abstract
Background: Preterm infants are born with immature organs, leading to morbidities such as necrotizing enterocolitis (NEC), a gut inflammatory disease associated with adverse feeding responses but also hemodynamic and respiratory instability. Skin-to-skin contact including “kangaroo care” may improve infant survival and health via improved vital functions (e.g., pulmonary, cardiovascular) and endocrine influences by adrenal glucocorticoids. Clinical effects of skin-to-skin contact for newborn siblings (“co-bedding”) are not known. Using NEC-susceptible Preterm pigs as models, we hypothesized that co-bedding and exogenous glucocorticoids improve vital functions and NEC resistance.Methods: In experiment 1, cesarean-delivered, formula-fed Preterm pigs were reared in incubators with (co-bedding, COB, n = 30) or without (single-bedding, SIN, n = 29) a sibling until euthanasia and tissue collection on day four. In experiment 2, single-bedded Preterm pigs were treated postnatally with a tapering dose of hydrocortisone (HC, n = 19, 1–3 mg/kg/d) or saline (CON, n = 19).Results: Co-bedding reduced NEC incidence (38 vs. 65%, p < 0.05) and increased the density of colonic goblet cells (+20%, p < 0.05) but had no effect on pulmonary and cardiovascular functions (respiration, blood pressure, heart rate, blood gases) or cortisol levels. There were limited differences in intestinal villous architecture and digestive enzyme activities. In experiment 2, HC treatment increased NEC lesions in the small intestine without any effects on pulmonary or cardiovascular functions.Conclusion: Co-bedding may improve gut function and NEC resistance independently of cardiorespiratory function and cortisol levels, but pharmacological cortisol treatment predispose to NEC. Preterm pigs may be a useful tool to better understand the physiological effects of co-bedding, neonatal stressors and their possible interactions with morbidities in Preterm neonates.
Highlights
Preterm birth interrupts intrauterine development and results in premature exposure of the developing fetus to the extra-uterine environment, leading to a range of morbidities, including necrotizing enterocolitis (NEC)
The vital functions of co-bedded and single-housed Preterm piglets were closely monitored for 72 h (Figure 2)
Skin-to-skin contact appears to provide organismwide benefits to Preterm infants, but detailed knowledge about physiological effects requires the use of animal models
Summary
Preterm birth (birth before 37 weeks’ gestation) interrupts intrauterine development and results in premature exposure of the developing fetus to the extra-uterine environment, leading to a range of morbidities, including necrotizing enterocolitis (NEC). Parent-infant skin-to-skin contact (termed “kangaroo care”) may serve to reduce negative stress effects, thereby increasing cardiovascular and respiratory stability in Preterm infants [3,4,5]. Skin-to-skin contact between infant siblings (termed “cobedding”) may provide the same benefits as kangaroo care, but few clinical studies are available and effects on survival, vital functions, NEC and infection rates are unknown [7]. The mechanisms whereby kangaroo care or co-bedding may improve survival and health remain unknown but could relate to changes in circulating cortisol levels, a key regulator of perinatal organ maturation and cardiovascular and respiratory stability [8]. Skin-to-skin contact including “kangaroo care” may improve infant survival and health via improved vital functions (e.g., pulmonary, cardiovascular) and endocrine influences by adrenal glucocorticoids. Using NEC-susceptible Preterm pigs as models, we hypothesized that co-bedding and exogenous glucocorticoids improve vital functions and NEC resistance
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
