住院皮肤护理可预测早产儿 12 个月的神经发育结果。

Molly F Lazarus, Virginia A Marchman, Edith Brignoni-Pérez, Sarah Dubner, Heidi M Feldman, Melissa Scala, Katherine E Travis
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摘要

目的:将早产儿在医院接受皮肤接触护理(STS)的经历与神经发育的长期结果联系起来的研究非常有限。本研究以极度早产儿(VPT)为样本,探讨了住院期间皮肤接触护理(STS)与 12 个月时神经发育评分之间的关系:研究设计和方法:对 181 名 VPT 婴儿的医疗记录进行了回顾性研究(结果:家庭平均每天接受约 17 分钟的 STS 护理(每周 2 天,每节课 70 分钟),但差异很大。STS 率的变化与 12 个月矫治后的结果呈正相关(r = 0.25,p .001)。在控制了GA、社会经济地位(SES)、健康敏锐度和探视频率后,STS率可明显预测12个月神经发育结果中6.2%的独特差异。每天增加 20 分钟的 STS 与 12 个月时神经发育结果增加 10 分(0.67 SDs)有关。SES、GA和婴儿健康敏锐度并没有缓和这些关系:结论:住院期间经历更多 STS 的 VPT 婴儿在 12 个月的神经发育评估中得分更高。研究结果证明,STS护理可为VPT婴儿提供持续到出生后第一年的神经保护。
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Inpatient Skin-to-Skin Care Predicts 12-month Neurodevelopmental Outcomes in Very Preterm Infants.

Objective: Limited research links hospital-based experiences of skin-to-skin (STS) care to longer-term neurodevelopmental outcomes in preterm children. The present study examined relations between inpatient STS and neurodevelopmental scores measured at 12 months in a sample of very preterm (VPT) infants.

Study design and methods: From a retrospective study review of medical records of 181 VPT infants (<32 weeks gestational age (GA)) we derived the STS rate, i.e., the total minutes of STS each infant received/day of hospital stay. We used scores on the Capute Scales from routine follow-up care at 12 months as the measure of neurodevelopmental outcome (n=181).

Results: Families averaged approximately 17 minutes/day of STS care (2 days/week, 70 minutes/session), although there was substantial variability. Variation in STS rate was positively associated with outcomes at 12 months corrected age ( r = 0.25, p < .001). STS rate significantly predicted 6.2% unique variance in 12-month neurodevelopmental outcomes, after controlling for GA, socioeconomic status (SES), health acuity, and visitation frequency. A 20-minute increase in STS per day was associated with a 10-point increase (.67 SDs) in neurodevelopmental outcomes at 12 months. SES, GA, and infant health acuity did not moderate these relations.

Conclusion: VPT infants who experienced more STS during hospitalization demonstrated higher scores on 12-month assessments of neurodevelopment. Results provide evidence that STS care may confer extended neuroprotection on VPT infants through the first year of life.

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