Cover Image

Biomarkers of stress in preterm newborns exposed to bath: a pilot study

Patrícia de Freitas, Amélia Fumiko Kimura

Abstract


Introduction: the corporal hygiene of the preterm newborn, although it is a recommended and routine practice, requires caution and safety for provoking disorganization in the autonomic system and homeostasis imbalance. Aim: to evaluate the variation of heart rate, oxygen saturation and salivary cortisol levels of preterm newborns submitted to conventional immersion baths and swaddled in sheets. Method: this is a randomized, pilot, cross-over clinical trial with 15 clinically stable preterm newborns. Results: the mean heart rate and oxygen saturation after the conventional immersion bath and swaddled in sheet did not present significant clinical and statistical differences. There was an increase in the salivary cortisol concentration when comparing the pre and post-bath values in the two bath techniques. Conclusion: there were no significant differences in stress biomarkers when comparing the two bathing techniques.

Keywords


Biomarkers; Infant, Premature; Heart Rate; Oxygenation; Skin Care; Neonatal Nursing

References


Santos J, Pearce SE, Stroustrup A. Impact of hospital-based environmental exposures on neurodevelopmental outcomes of preterm infants. Curr Opin Pediatr. 2015;27(2):254-60.

Mörelius E, He H-G, Shorey S. Salivary cortisol reactivity in preterm infants in neonatal intensive care: an integrative review. Bielajew C, Mileva G, eds. Int J Environ Res Public Health. 2016;13(3):337. doi:10.3390/ijerph13030337.

Lyngstad LT, Tandberg BS, Storm H, Ekeberg BL, Moen A. Does skin-to-skin contact reduce stress during diaper change in preterm infants? Early Hum Dev. 2014 Apr;90(4):169-72.

American Heart Association. Highlights of the 2015 American Heart Association. Guidelines Update for CPR and ECC. Am Heart Assoc. 2015 [cited 2016 Jul 25]. Available from: https://eccguidelines.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-English.pdf

Thiriez G, Mougey C, Vermeylen D, Wermenbol V, Lanquart J, Lin SJ, et al. Altered autonomic control in preterm newborns with impaired neurological outcomes. Clin Auton Res. 2015;25(4):233-42.

Peng NH, Bachman J, Chen CH, Huang LC, Lin HC, Li TC. Energy expenditure in preterm infants during periods of environmental stress in the neonatal intensive care unit. Jpn J Nurs Sci. 2014;11(4):241-7.

Smith SL, Haley S, Slater H, Moyer-Mileur LJ. Heart rate variability during caregiving and sleep after massage therapy in preterm infants. Early Hum Dev. 2013;89(8):525-529.

Cabral D. M., Antonini S. R. R., Custódio R. J., Martinelli C. E., Jr., Da Silva C. A. B. Measurement of salivary cortisol as a marker of stress in newborns in a neonatal intensive care unit. Horm Res Paediatr. 2013;79(6):373–378. doi: 10.1159/000351942

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Atenção humanizada ao recém-nascido de baixo peso: Método Canguru. 2ªed. Brasília: Editora do Ministério da Saúde. 2011 [acesso em 25 mai 2016]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/metodo_canguru_manual_tecnico_2ed.pdf

Dezhdar S, Jahanpour F, Firouz Bakht S, Ostovar A. The effects of Kangaroo Mother Care and swaddling on venipuncture pain in premature neonates: a randomized clinical trial. Iran Red Crescent Med J. 2016;18(4):e29649. doi:10.5812/ircmj.29649.

Ho LP, Ho SS, Leung DY, So WK, Chan CW. A feasibility and efficacy randomised controlled trial of swaddling for controlling procedural pain in preterm infants. J Clin Nurs. 2016 Feb;25(3-4):472-82. doi: 10.1111/jocn.13075.

Abdeyazdan Z, Mohammadian-Ghahfarokhi M, Ghazavi Z, Mohammadizadeh M. Effects of nesting and swaddling on the sleep duration of premature infants hospitalized in neonatal intensive care units. Iran J Nurs Midwifery Res. 2016;21(5):552-556. doi:10.4103/1735-9066.193422.

Pease AS, Fleming PJ, Hauck FR, Moon RY, Horne RS, L'Hoir MP, Ponsonby AL, Blair PS. Swaddling and the risk of Sudden Infant Death Syndrome: a meta-analysis. Pediatrics. 2016 Jun;137(6). pii: e20153275. doi: 10.1542/peds.2015-3275. Review

Antonov NK, Ruzal-Shapiro CB, Morel KD, Millar WS, Kashyap S, Lauren CT, Garzon MC. Feed and wrap MRI technique in infants. Clin Pediatr (Phila). 2016 Nov 20. pii: 0009922816677806. Disponível em http://journals.sagepub.com/doi/abs/10.1177/0009922816677806?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed

Edraki M, Paran M, Montaseri S, Razavi Nejad M, Montaseri Z. Comparing the effects of swaddled and conventional bathing methods on body temperature and crying duration in premature infants: a randomized clinical trial. J Caring Sci. 2014;3(2):83-91. doi:10.5681/jcs.2014.009.

Wellek S, Blettner M. On the proper use of the crossover design in clinical trials: Part 18 of a series on evaluation of scientific publications. Dtsch Arztebl Int. 2012;109(15):276-281. doi:10.3238/arztebl.2012.0276.

Zeiner V, Storm H, Doheny KK. Preterm infants’ behaviors and skin conductance responses to nurse handling in the NIC. J Matern Fetal Neonatal Med. 2016; 29(15):2530-5.

De Oliveira Tobinaga WC, de Lima Marinho C, Abelenda VLB, de Sá PM, Lopes AJ. Short-term effects of hydrokinesiotherapy in hospitalized preterm newborns. Rehabil Res Pract. 2016;2016:9285056. doi:10.1155/2016/9285056.

Cândia MF, Osaku EF, Leite MA, et al. Influence of prone positioning on premature newborn infant stress assessed by means of salivary cortisol measurement: pilot study. Rev Bras Ter Intensiva. 2014;26(2):169-175. doi:10.5935/0103-507X.20140025

Maas C, Ringwald C, Weber K, Engel C, Poets CF, Binder G, et al. Relationship of salivary and plasma cortisol levels in preterm infants: results of a prospective observational study and systematic review of the literature. Neonatology. 2014; 105(4):312-8.




DOI: https://doi.org/10.17665/1676-4285.20185920



 

The articles published in Online Brazilian Journal of Nursing are indexed, classified, linked, or summarized by:

 

Affiliated to:

Sources of Support:

 

The OBJN is linked also to the main Universities Libraries around the world.

Online Brazilian Journal of Nursing. ISSN: 1676-4285

Creative Commons License
This work is licensed under a Creative Commons:Noncommercial-No Derivative Works License.