ABSTRACT
BACKGROUND: Preterm birth and prolonged neonatal hospitalization are potential sources of stress for mothers of preterm and low birth weight infants. AIM: To evaluate maternal stress and its association with neurobehavioral indicators of preterm infants during hospitalization in the neonatal intensive care unit. METHODS: A cross-sectional study was conducted in a neonatal intensive care unit of a hospital in Goiânia, Brazil. The study included preterm and low birth weight infants of both genders and their mothers. The Parental Stressor Scale: Neonatal Intensive Care Unit and the Neurobehavioral Assessment of the Preterm Infant were respectively applied to mothers and infants in the neonatal intensive care unit. RESULTS: The study involved 165 premature infants and their mothers. The mean age of the mothers was 26.3 years and most had a high school education level (57.6%). Mothers perceived the experience of having an infant in the neonatal intensive care unit as moderately stressful (2.96 ± 0.81). The parental role alteration (4.11 ± 1.03) and sights and sounds (2.15 ± 0.90) subscales exhibited the highest and lowest stress levels, respectively. Significant correlations (rho < -0.3; p < 0.05) were found between maternal stress and neurobehavioral indicators of infants. In the multivariate analysis, low leg tone was a predictor of higher maternal stress. Low tone and limited arm movement were predictors of higher maternal stress in the maternal role item. CONCLUSIONS: The experience of having a preterm infant hospitalized was considered moderately stressful for mothers. Maternal stress levels were significantly correlated with low scores on neonatal neurobehavioral indicators.
ABSTRACT
Pain management is challenging in neonatal care. We aimed to compare the effects of gentle touch and sucrose on pain relief during suctioning in premature newborns (PTNB). This crossover randomized clinical trial enrolled PTNBs with low birth weight, hemodynamically stable, and requiring suctioning during hospitalization in the neonatal intensive care unit. PTNBs underwent three different suctioning procedures. The first was performed without intervention (baseline). Right after, PTNBs were randomly allocated (sucrose and gentle touch or vice versa) to the next two suctioning procedures. Two validated scales assessed pain: the Neonatal Infant Pain Scale (NIPS) and the Premature Infant Pain Profile-Revised (PIPP-R). We evaluated 50 PTNBs (mean of 28 weeks) with a mean low birth weight of 1050 g; most were under continuous positive airway pressure 37 (74%) and mechanical ventilation 41 (82%). Gentle touch was efficacious for pain relief since NIPS (p = 0.010) compared to baseline. Sucrose was also effective in reducing pain NIPS and PIPP-R (p < 0.001). Although the two interventions reduced pain, no difference was observed between gentle touch and sucrose.