Association between early onset of skin-to-skin contact and mother-infant interaction at hospital discharge and six months of corrected age among preterm infants.

OBJECTIVE: To compare mother-infant interaction between hospital discharge and at six months of corrected age of infants born ≤32 weeks and investigate the association between the onset of skin-to-skin contact and the difference in mother-infant interaction between discharge and six months of corrected age (CA) among preterm infants. MATERIAL AND METHODS: Prospective observational study, in which 72 mother-infant dyads were evaluated. Preterm newborns (born with gestational age ≤ 32 weeks of gestational age) from two public maternity hospitals were assessed by means of video macro analysis of the mother-infant interaction according to the parameters adopted by the Mother-Baby Observation Protocol 0-6 (POIMB), at hospital discharge and at six months of corrected gestational age. Such variables as socioeconomic conditions, depression and maternal anxiety were controlled. Multivariate model was built. RESULTS: Onset skin-to-skin contact within three days of life increased by 1.30 points for the best interactive infant behavior at discharge for the six months of CA. In addition, in relation to the tuning of the mother-infant dyad, the initiation of skin-to-skin contact at 20 days of life reduced 1.0 point significantly. Multiparous mothers or those exposed to cigarette smoke performed worse in the development of the dyad. CONCLUSION: The preterm newborn should initiate skin-to-skin contact early and, whenever possible, by the third day of life to favor mother-infant interaction.

Neuropsychomotor development in children born preterm at 6 and 12 months of corrected gestational age.

OBJECTIVE: To assess the incidence of neuropsychomotor developmental delay at 6 and 12 months of corrected gestational age in children born at 32 gestational weeks or less. METHODS: A descriptive and prospective study was carried out at two public maternity hospitals. Between April 2017 and January 2019, we assessed 133 children without any known risk factors for neuropsychomotor developmental delay. The Bayley III scale was used to evaluate cognitive and motor development. The p value of the numerical variables was calculated using the Mann-Whitney test, whereas proportions of categorical variables were compared using the Z-test. RESULTS: The mean maternal age was 26±6.9 years,78.8% were from middle and lower economic classes, and 57.1% of the analyzed children were female. Children presented with a higher incidence of delay at 12 months than at 6 months (10.3 and 2.3% at 12 and 6 months, respectively, for the cognitive score; 22.7 and 12% at 12 and 6 months, respectively, for the composite motor score; and 24.7 and 8.4% at 12 and 6 months, respectively, for the fine motor score). CONCLUSIONS: Cognitive and motor developmental delays were significant, with the highest incidence at 12 months. The results of this study encourage further research on this topic, since the exclusion criteria were comprehensive and the delays in neuropsychomotor development were significant.

RELATIONSHIP BETWEEN THE USE OF KANGAROO POSITION ON PRETERM BABIES AND MOTHER-CHILD INTERACTION UPON DISCHARGE. / RELAÇÃO DA DURAÇÃO DA POSIÇÃO CANGURU E INTERAÇÃO MÃE-FILHO PRÉ-TERMO NA ALTA HOSPITALAR.

OBJECTIVE: To analyze the influence of the Kangaroo Position duration in the initial interactions between mothers and preterm infants. METHODS: This is an exploratory prospective observational study that analyzed the mother-infant interaction during breastfeeding, before hospital discharge. All eligible newborns, with a gestational age of 28-32 weeks and a birth weight of 1,000-1,800 g from June 11 to September 31, 2014 were included. The films of the interaction were evaluated by the "Mother-Baby Interaction Protocol 0-6 months" tool. The duration of the Kangaroo Position during all the hospitalization period was correlated with the interaction between mother and preterm infant. RESULTS: The longer the dyad spent time in the Kangaroo Position, the more the newborns made physical contact attempts with their mothers during breastfeeding (r=0.37; p=0.03); and the longer the time in the Kangaroo Position, the less the mothers talked to their children (r=-0.47; p=0.006). CONCLUSIONS: Longer periods in the Kangaroo Position stimulates the initial exchanges of contact between preterm infant with his mother, which suggests a higher alert status of the newborn and a better availability for interactions with the mother during breastfeeding.

OBJETIVO: Analisar a influência da duração da Posição Canguru nas interações iniciais da díade mãe-filho pré-termo. MÉTODOS: Trata-se de um estudo observacional, prospectivo exploratório, que analisou, por meio de filmagens, a interação mãe-filho, durante a amamentação, previamente à alta hospitalar, utilizando o "Protocolo de Interação Mãe-Bebê 0 a 6 meses". Foi correlacionado o tempo da Posição Canguru durante toda a internação hospitalar e a interação mãe-filho pré-termo. Todos os recém-nascidos elegíveis (idade gestacional entre 28 e 32 semanas e peso ao nascimento entre 1000 e 1800 g) foram incluídos no período de 11 de junho a 31 de setembro de 2014. RESULTADOS: Quanto maior o tempo em Posição Canguru, mais os recém-nascidos realizaram tentativas de contato físico com as mães durante a amamentação (r=0,37; p=0,03); e quanto maior o tempo na Posição Canguru, menos as mães conversaram com os filhos (r=-0,47; p=0,006). CONCLUSÕES: Os dados apontam que o maior tempo de Posição Canguru favorece as trocas iniciais de contato entre o filho pré-termo e a mãe, o que sugere maior estado de alerta e melhor disponibilidade do recém-nascido para interações com a mãe durante a amamentação.

Relação da duração da posição canguru e interação mãe-filho pré-termo na alta hospitalar / Relationship between the use of kangaroo position on preterm babies and mother-child interaction upon discharge

RESUMO Objetivo: Analisar a influência da duração da Posição Canguru nas interações iniciais da díade mãe-filho pré-termo. Métodos: Trata-se de um estudo observacional, prospectivo exploratório, que analisou, por meio de filmagens, a interação mãe-filho, durante a amamentação, previamente à alta hospitalar, utilizando o "Protocolo de Interação Mãe-Bebê 0 a 6 meses". Foi correlacionado o tempo da Posição Canguru durante toda a internação hospitalar e a interação mãe-filho pré-termo. Todos os recém-nascidos elegíveis (idade gestacional entre 28 e 32 semanas e peso ao nascimento entre 1000 e 1800 g) foram incluídos no período de 11 de junho a 31 de setembro de 2014. Resultados: Quanto maior o tempo em Posição Canguru, mais os recém-nascidos realizaram tentativas de contato físico com as mães durante a amamentação (r=0,37; p=0,03); e quanto maior o tempo na Posição Canguru, menos as mães conversaram com os filhos (r=-0,47; p=0,006). Conclusões: Os dados apontam que o maior tempo de Posição Canguru favorece as trocas iniciais de contato entre o filho pré-termo e a mãe, o que sugere maior estado de alerta e melhor disponibilidade do recém-nascido para interações com a mãe durante a amamentação.

ABSTRACT Objective: To analyze the influence of the Kangaroo Position duration in the initial interactions between mothers and preterm infants. Methods: This is an exploratory prospective observational study that analyzed the mother-infant interaction during breastfeeding, before hospital discharge. All eligible newborns, with a gestational age of 28-32 weeks and a birth weight of 1,000-1,800 g from June 11 to September 31, 2014 were included. The films of the interaction were evaluated by the "Mother-Baby Interaction Protocol 0-6 months" tool. The duration of the Kangaroo Position during all the hospitalization period was correlated with the interaction between mother and preterm infant. Results: The longer the dyad spent time in the Kangaroo Position, the more the newborns made physical contact attempts with their mothers during breastfeeding (r=0.37; p=0.03); and the longer the time in the Kangaroo Position, the less the mothers talked to their children (r=-0.47; p=0.006). Conclusions: Longer periods in the Kangaroo Position stimulates the initial exchanges of contact between preterm infant with his mother, which suggests a higher alert status of the newborn and a better availability for interactions with the mother during breastfeeding.