Preterm Infants In NICU Research Articles

Camera-Based Cardiorespiratory Monitoring of Preterm Infants in NICU

Camera-Based Cardiorespiratory Monitoring of Preterm Infants in NICU

Nurses' Performance Regarding Gravity Gavage Way Versus Injection Force on Gastric Residual Volume Among Preterm Infants in NICU

Nurses' Performance Regarding Gravity Gavage Way Versus Injection Force on Gastric Residual Volume Among Preterm Infants in NICU

The clinical experience of early skin-to-skin contact combined with non-nutritive comfort sucking in mothers of preterm infants: a qualitative study

BackgroundIn most areas of China, mothers typically do not participate in early care of preterm infants in NICU. This study aims to examine the early experience of mothers of preterm infants participating in skin-to-skin contact combined with non-nutritive comfort sucking in China.MethodsThis qualitative research study used one-on-one, face-to-face, semi-structured in-depth interviews. Eighteen mothers who participated in early skin-to-skin contact combined with non-nutritive comfort sucking were interviewed in the NICU of a tertiary children’s hospital in Shanghai between July and December 2020. Their experiences were analyzed using the inductive topic analysis method.ResultsFive themes about skin-to-skin contact combined with non-nutritive comfort sucking were identified, including alleviation of maternal anxiety and fear during mother infant separation, reshaping the maternal role, promotion of active breast pumping, enhances the mother’s willingness to actively breast feed and building the maternal confidence in baby care.ConclusionSkin-to-skin contact combined with non-nutritive comfort sucking in the NICU can not only enhance the identity and responsibility of the mother’s role, but also provide non-nutritive sucking experience for promoting the establishment of oral feeding in preterm infants.

Point-of-care hemoglobin analysis vs laboratory assay in preterm infants in NICU: cost effectiveness and neuroprotective implications

Point-of-care hemoglobin analysis vs laboratory assay in preterm infants in NICU: cost effectiveness and neuroprotective implications

Prone sleeping affects cardiovascular control in preterm infants in NICU.

Prone sleeping is used in preterm infants undergoing intensive care to improve respiratory function, but evidence suggests that this position may compromise autonomic cardiovascular control. To test this hypothesis, this study assessed the effects of the prone sleeping position on cardiovascular control in preterm infants undergoing intensive care treatment during early postnatal life. Fifty-six preterm infants, divided into extremely preterm (gestational age (GA) 24-28 weeks, n = 23) and very preterm (GA 29-34 weeks, n = 33) groups, were studied weekly for 3 weeks in prone and supine positions, during quiet and active sleep. Heart rate (HR) and non-invasive blood pressure (BP) were recorded and autonomic measures of HR variability (HRV), BP variability (BPV), and baroreflex sensitivity (BRS) using frequency analysis in low (LF) and high (HF) bands were assessed. During the first 3 weeks, prone sleeping increased HR, reduced BRS, and increased HF BPV compared to supine. LF and HF HRV were also lower prone compared to supine in very preterm infants. Extremely preterm infants had the lowest HRV and BRS measures, and the highest HF BPV. Prone sleeping dampens cardiovascular control in early postnatal life in preterm infants, having potential implications for BP regulation in infants undergoing intensive care.

Glucose concentrations in enterally fed preterm infants.

Determine the prevalence of glucose concentrations below the Pediatric Endocrine Society (PES) term and late preterm-focused guideline target for mean glucose concentrations (≥70 mg/dL) among preterm NICU infants on full enteral nutrition and assess the impact on monitoring practices. Retrospective cohort study. We analyzed 1717 infants who were at least 2 days old and 48 hours after parenteral fluids were discontinued. Glucose concentrations were ≥70, 60-69, 50-59, and <50 mg/dL in 76.6, 16.2, 5.9, and 1.3% of measurements, respectively. In multivariate models, concentrations <60 mg/dL were common among male infants at lower postnatal age, small-for-gestational age, and born to women with hypertension (p < 0.05). After PES guideline, infants were more likely to have >3 glucose measurements (p < 0.05). Glucose concentrations <70 mg/dL are not uncommon among preterm infants receiving full enteral nutrition. Monitoring increased after guideline publication. Applying PES threshold to well-appearing preterm infants may promote increased monitoring and intervention without clear long-term benefit.

Effects of motion and audio-visual redundancy on upright and inverted face and feature preferences in 4-13-month old pre- and full-term NICU graduates

NICU infants are reported to have diminished social orientation and increased risk of socio-communicative disorders. In this eye tracking study, we used a preference for upright compared to inverted faces as a gauge of social interest in high medical risk full- and pre-term NICU infants. We examined the effects of facial motion and audio-visual redundancy on face and eye/mouth preferences across the first year. Upright and inverted baby faces were simultaneously presented in a paired-preference paradigm with motion and synchronized vocalization varied. NICU risk factors including birth weight, sex, and degree of CNS injury were examined. Overall, infants preferred the more socially salient upright faces, making this the first report, to our knowledge, of an upright compared to inverted face preference among high medical risk NICU infants. Infants with abnormalities on cranial ultrasound displayed lower social interest, i.e. less of a preferential interest in upright faces, when viewing static faces. However, motion selectively increased their upright face looking time to a level equal that of infants in other CNS injury groups. We also observed an age-related sex effect suggesting higher risk in NICU males. Females increased their attention to the mouth in upright faces across the first year, especially between 7–10 months, but males did not. Although vocalization increased diffuse attention toward the screen, contrary to our predictions, there was no evidence that the audio-visual redundancy embodied in a vocalizing face focused additional attention on upright faces or mouths. This unexpected result may suggest a vulnerability in response to talking faces among NICU infants that could potentially affect later verbal and socio-communicative development.

Discharge readiness of Indonesian mother with preterm infant in NICU

This study aimed to describe Indonesian mother readiness for discharge with Low Birth Weight (LBW) infant. This paper is part of larger study and using quantitative study. Sampling method was used in this study was convenience sampling to 139 mothers with LBW infant in public hospital in Makassar City, Indonesia. Respondents were given self-assessed questionnaire about their readiness for discharge within 24h before they go home. Majority (94.5%) of mothers reported that they were ready to go home and 90.6% perceived that their LBW infants were ready for hospital discharge as assessed by the dichotomous answer (i.e. Yes vs. No). The mothers mean overall score of the RHDS was 199 (29.752) which maximum total score 290. The scores on an item of the RHDS was 6.86 (3.164) which maximum item score 10. Indonesian mother's readiness had lower readiness than other countries. The discharge education program was needed to enhance mother's knowledge of readiness for hospital discharge.

The Effect of Expressive Writing on Postpartum Depression and Stress of Mothers with a Preterm Infant in NICU.

This study was conducted to investigate the effects of expressive writing on postpartum depression and stress of mothers with a preterm infant in NICU. This clinical trial was carried out on 91 mothers whose infants were in NICU. Subjects were assigned to intervention and control groups. In the intervention group, subjects were asked to start expressive writing from the third day of hospitalization in NICU and continue it until the tenth day. EPDS, PSS: NICU, and PSS-14 COHEN were completed by all the mothers on days 3 and 10, and 1-3months after the admittance. Mean EPDS score was obtained as 9.65 ± 5.28, 9.23 ± 5.41, 8.19 ± 4.45, and 7.60 ± 4.65, respectively, for control group at days 3 and 10, and 1-3months after hospitalization, and it was also obtained as 9.62 ± 5.89, 6.04 ± 3.39, 2.95 ± 2.41, and 2.44 ± 2.01, respectively, for the intervention group at days 3 and 10, and 1-3months after hospitalization (p < 0.001). Mean PSS-14 COHEN score was lower for intervention group similar to the control group (p < 0.005). Results of the independent samples T-test showed higher stress scores for the control group before and after the intervention, but the difference was not statistically significant (p = 0.08). Mothers with an infant in NICU experienced a high level of postpartum depression and stress. Thus, according to findings of this study, expressive writing is proposed as a convenient and inexpensive means to reduce levels of postpartum depression and stress.

Chinese Parents' Lived Experiences of having Preterm Infants in NICU: A Qualitative Study

PurposeTo explore Chinese parents’ experiences and expectations of having preterm infants in a Chinese neonatal intensive care unit. Design and methodsA qualitative descriptive design with semi-structured interviews was used to describe the experiences and expectations of parents of preterm infants in a neonatal intensive care unit in the central region of China. Purposive sampling was adopted to recruit parents (n = 15) of preterm infants and data were collected by face-to-face interviews from January to May 2018. Themes were identified by thematic analysis. This study followed the consolidated criteria for reporting qualitative research (COREQ). ResultsFive themes emerged from the analysis: (1) mixed emotional experiences; (2) separation from the infants; (3) perceived incompetence in taking care of preterm infants; (4) obtained support through various sources; (5) desired more from healthcare professionals. ConclusionsParents experienced additional emotional burdens due to separation from their infants as well as a lack of an effective approach to their associated needs. While NICU staff adopted several strategies to help parents cope with their infant hospitalization, these parents still expected to receive more support from healthcare providers to meet their needs. Practice implicationsHealthcare providers should be more aware of parents' various needs in neonatal intensive care units and of their important role as constant caregivers. Hospital-based neonatal care should be specifically designed to supply positive support and necessary strategies for parents to strengthen their confidence in parenting infants.

Breast milk expression for premature infant in the neonatal intensive care unit: A review of mothers’ perceptions

To identify the existing literature on mothers' perception towards the impact of expressing breast milk for their premature infant in the neonatal intensive care unit. Guided by the PRISMA Statement review checklist, a systematic review of the Scopus and Web of Science database has identified 10 related studies. The articles were assessed and analyzed after evaluated using The Joanna Briggs Institute Critical Appraisal tools (JBI). Thematic analysis was obtained after using Nvivo software as a tool for data analysis by author. Further review of these articles resulted in three main themes-maternal changes during expressing breast milk, pumping challenges and impact of motivation factors to initiating lactation. Expressing breast milk should be recognized as an important way to restructure motherhood with a preterm infant in NICU. However, maintaining expressed breast milk during preterm infants' treatment period in NICU may increase stress and difficulties for some mothers. Some recommendations are emphasized in relation to the need for more qualitative studies in this issue, which is to have a specific and standard systematic review method for guide research synthesis in context of climate change adaptation.

Effect of reading to preterm infants on measures of cardiorespiratory stability in the neonatal intensive care unit.

To evaluate the impact of parental bedside reading (PR) on cardio-respiratory (CR) stability of preterm infants. Prospective examination of the impact of PR on CR stability in preterm NICU infants. CR data from 3 time points: pre-reading (3 and 1 h before reading), during PR, and post-reading (1 h after reading) were compared. Eighteen infants born at 23-31wks gestation, and 8 to 56 days old, were enrolled. Episodes of oxygen desaturation to <85% were fewer during PR as compared to the pre-reading periods and were fewer with live and maternal PR. Preterm infants showed fewer desaturation events less than 85% during PR than prior to reading exposure. This effect persisted up to 1 h after reading exposure. Desaturation events were fewer with live and maternal PR. Voice exposure can be an important way for parents to participate in the care of their preterm infants.

Influence of home care in hospital on the post-discharged quality life of preterm infants

Objective To explore the effect of home care in hospital on the improvement of the post-discharged quality of life in preterm infants. Methods Seventy-four preterm infants who were hospitalized in NICU of Kunming Children's Hospital from August of 2015 to July of 2016 were included and divided into the control group and the invention group at random. Thirty-seven preterm infants were included into each group. The preterm infants in the control group accepted the conventional treatment and nursing in hospital. Besides the conventional treatment and nursing, the parents of the preterm infants in the intervention group accepted the preterm infant nursing which simulated the home environment when the infants were in hospital. Using the follow-up investigation method, the weight increasing, the rate of re-visiting the doctor of the preterm infants in the two groups were observed when they were discharged. Results One month after discharge the weight increasing of the preterm infants in the intervention group was (0.987±0.231) kg, which was significantly higher compared to the control group (0.760±0.179) kg (t=15.22, P<0.05) . One month after discharge the rate of re-visiting the doctor in the intervention group was 1, which was significantly fewer compared to the control group (χ2=8.86, P<0.05) . Conclusions Home care in hospital increases the parents' ability of taking care of preterm infants effectively, improves the health level and the development of preterm infants in NICU when they were discharged. Key words: Infant, preterm; Quality of life; Home care in hospital

The Effects of Non-Nutritive Sucking and Pre-Feeding Oral Stimulation on Time to Achieve Independent Oral Feeding for Preterm Infants.

Background:The survival rates of preterm infants has increased over the last years, but oral feeding difficulties are the most common problems encountered by them Objectives:This study aimed at comparing the effects of non-nutritive sucking (NNS) and pre-feeding oral stimulation on feeding skills, length of hospital stay and weight gain of 26-32 weeks gestational age preterm infants in NICU, to determine the more effective intervention.Patients and Methods:Thirty-two preterm infants were assigned randomly into three groups. One intervention group received pre-feeding oral stimulation program and the other received non-nutritive sucking stimulation, while the control group received a sham intervention. Gestational age of infants was calculated during 1, 4 and 8 oral feeding and discharge time from NICU. The infants’ weights were measured weekly from birth and at discharge time.Results:Mean gestational age on 8 time oral feeding per day, in 3 groups was not significant (P = 0.282). Although NNS and pre-feeding oral stimulation groups has fulfilled this criterion 7.55 and 6.07 days sooner than the control group, respectively (a result which is of great clinical and economic importance), but the difference did not reach statistical significance. Weight gaining at discharge time in NNS group was significantly higher than control and pre-feeding oral stimulation groups (P < 0.05).Conclusions:This study revealed that pre-feeding oral stimulation and NNS programs both were effective on oral feeding skills and weight gaining of the immature newborns. Yet, it seems that NNS program was more effective than pre-feeding oral stimulation on weight gaining.

Impact of Oral Sensory Motor Stimulation on Feeding Performance, Length of Hospital Stay, and Weight Gain of Preterm Infants in NICU

Background:One of the limiting factors for early hospital discharge in preterm infants is their inability to feed sufficiently to obtain consistent weight gain. Therefore, feeding difficulty is one of the most significant issues with which a preterm infant is faced.Objectives:The purpose of this study was to examine the effect of oral sensory motor stimulation on feeding performance, length of hospital stay, and weight gain in preterm infants at 30 - 32 weeks of gestational age.Patients and Methods:Premature infants (n = 20) were randomly assigned to experimental and control groups. The experimental group received oral sensory motor stimulation of the oral structures (15 minutes / day) for 10 successive days, while these stimulations were not offered to the control group. Days elapsed to achieve oral feeding, length of hospital stay, and weight gain in the two groups were assessed.Results:Transition to oral feeding was acquired significantly earlier in the infants in the experimental group than in the controls: 13 and 26 days, respectively (P < 0.001). Likewise, the length of hospitalization was significantly shorter in the experimental group than in the control group: 32 days and 38 days, correspondingly (P < 0.05). The two groups showed no significant difference in terms of weight gain in the first, second, third, and fourth weeks of birth: first week: 100 vs. 110; second week: 99 vs. 111; third week: 120 vs. 135; and fourth week: 129 vs. 140.Conclusions:The present research revealed that the number of days to reach oral feeding in our preterm babies was decreased by oral motor stimulation, which in turn conferred earlier hospital discharge.

G105 Pregnancy and Premature Neonatal Outcomes in Vitamin D Deficiency

BackgroundHypovitaminosis D is widespread among pregnant women and their infants. Recent studies implicate Vitamin D as having anti-inflammatory effects which may be beneficial in preterm infants who are at high...

Lutein and zeaxanthin supplementation in preterm infants in NICU: Preliminary data from a multicentre RCT

Preterm infants are at high risk of oxidative stress-induced damage and diseases, including severe multifactorial outcomes of prematurity such as ROP, NEC and BPD. Human milk feedings of preterms is speculated having a protective role towards these diseases, namely against ROP and NEC. The carotenoids (lutein, b-carotene, and zeaxanthin) are a family of polyene, lipophilic molecules found in human milk but not in formulas. These molecules might account for the protective role of human milk, providing protection against both light-induced and metabolic oxidative damages in the retina and in other developing tissues. The aim of this study was to evaluate the relationships of supplemented carotenoids (lutein and zeaxanthin) with the outcomes of preterm infants, namely ROP, NEC and BPD. We report the preliminary data of a multicentre RCT conducted in three tertiary NICUs of Italy. All VLBW infants < 33 wks g.a. were eligible. They were randomized to lutein/zeaxanthin supplementation (14 drops, i.e. 0.5 ml, meaning 0.14 mg of lutein and 0.0006 mg of zeaxanthin; LuteinOfta gtt, NEOOX Division of SOOFT Italia s.p.a., Montegiorgio, Italy; group A) or placebo (same amount of glucose solution; group B) from birth till the 36th wk g.a. corrected age. Drugs and placebo were administered in a single oral daily dose. The primary outcomes were ROP (threshold and all-stage), NEC (> 2nd stage) and BPD (defined as the need for oxygen supplementation at 36 wks of age). Surveillance for detection of these diseases, as well as for intolerance/adverse effects was performed till discharge. Measurements of serum liver enzyme values were performed at 4 wks of age. This preliminary analysis included 107 infants. Their clinical and demographical characteristics did not differ between the two groups. Overall, threshold ROP incidence tended to be lower in 54 treated (9.4%) vs. 53 not-treated (13.0%) infants ( p = 0.39). The same occurred for BPD (3.8% vs. 13.0%; p = 0.08) and NEC (2.1 vs. 4.8%; p = 0.45). Of note, treatment was associated with less need of mechanical ventilation (8 vs. 14 days), lower peak levels of bilirubinemia (9 mg% vs. 10 mg%), and less days of stay in NICU (38 vs. 42 days). No adverse effects putatively attributable to the treatment were documented. Based on these preliminary data from an RCT, lutein/zeaxanthin supplementation in VLBW infants was well tolerated and associated with a trend towards lower incidences of threshold ROP, NEC and BPD. These trends need to be confirmed and to achieve significance on larger sample sizes. We speculate that carotenoids are important nutrients in decreasing the severity of oxidative stress-related diseases of prematurity.

The Effect of Small for Gestational Age on Outcomes of Very Preterm Nicu Infants in Canada

The Effect of Small for Gestational Age on Outcomes of Very Preterm Nicu Infants in Canada

Type and number of sites colonized by fungi and risk of progression to invasive fungal infection in preterm neonates in neonatal intensive care unit

Retrospective cohort study to assess if different patterns of Candida colonization determine different risks of progression to invasive fungal infection (IFI) in preterm neonates in NICU. Weekly surveillance cultures from all neonates weighing at birth <1500 g admitted over a 6-year period were reviewed. Infants with available results from at least 3 cultures/week and from at least 4 different sites were enrolled and identified by the number of sites involved [1-2 (low-grade), 3 or more (high-grade)] and type (low-risk, if colonization was recovered from skin, stool, ear canal swab, gastric aspirate, nasopharynx secretions, endotracheal tube; high-risk, from urine, catheter tip, drains, surgical devices). Progression rates from colonization to IFI were calculated for each subgroup. Univariate analysis was performed looking for significant associations between IFI and a number of risk factors, including the different subgroups of colonization. Multiple logistic regression assessed all significantly (P<0.05) associated risk factors. In the 405 eligible infants, overall colonization rate was 42.9%, IFI rate 9.9%, overall progression rate to IFI 0.23, the latter being significantly higher in high-grade or high-risk than in low-grade or low-risk colonized infants (0.59 vs. 0.18, P=0.001; 0.44 vs. 0.11, P<0.001, respectively). Infants with concomitant high-grade + high-risk colonization had 4-fold higher risk of progression than any other colonized infant, and 7-fold higher risk than infants concomitantly low-grade + low-risk colonized (P<0.001). At multivariate analysis, high-grade and high-risk colonization (P=0.001 for both), birth weight (P=0.02) and presence of central venous line (P=0.04) remained independent predictors of IFI. Density and severity of fungal colonization condition the progression to IFI in preterm infants in NICU, and certain patterns of colonization are independent predictors of IFI. Increased culture surveillance and prophylactic measures should be addressed to preterm colonized infants in NICU featuring the most risky colonization patterns.

Identification of development and autonomic nerve activity from heart rate variability in preterm infants

Heartbeat intervals, which are determined basically by regular excitations of the sinoatrial node, show significant fluctuation referred to as the heart rate variability (HRV). The HRV is mostly due to nerve activities through the sympathetic and parasympathetic branches of the autonomic nervous system (ANS). In recent years, it has been recognized that the HRV shows a greater complexity than ever expected, suggesting that it includes much information about ANS activities. In this study, we investigated relationship between HRV and development in preterm infants. To this end, heartbeat intervals were continuously recorded from 11 preterm infants in NICU. The recording periods were ranging from several days to weeks depending on the individuals. The HRV at various ages was then characterized by several indices. They include power spectrum as well as the mean and standard deviation of the series. For the power spectrum, the low-frequency band power (LF), high-frequency band power (HF), LF/HF (the ratio between LF and HF), β (scaling exponent of the spectrum) were estimated. The detrended fluctuation analysis (DFA) was also employed to obtain short- and long-range scaling exponents. Each of these indices showed a correlation with the age. We showed that the long-range scaling exponent, derived from the DFA, was most significantly correlated with the age, suggesting that it could be a robust index to characterize the development of preterm infants.