Treviño BX, Luna MM, Iglesias LJ, Bernárdez ZI, Braverman BA

Language: Spanish
References: 9
Page: 261-265
PDF size: 233.25 Kb.

ABSTRACT

Introduction: The preterm newborn faces various physiological changes in the stimuli-loaded environment of a neonatal intensive care unit (NICU). An important cause of stress, postural anomalies and altered muscle tone acquisition is the lack of a body-support aid. Objective: To compare the use of two body-support aids to optimize posture and muscle tone in preterm neonates. Material and methods: Prospective, longitudinal study that included preterm neonates born in Hospital Español de México. The newborns were assigned into three groups according to the body-support aid: 1) «uterus» positioning aid, 2) neonatal nest, 3) control group. Once the patient was discharged, an assessment of seven postural and tone anomalies was made; a score of zero meant no anomalies. Logistic regression models were adjusted with the intention to determine the association between the body-support aid and each of the studied parameters; a linear regression model established the association of the support aid with the assessment score. Results: A total of 43 newborns were studied; 30.2% used the neonatal nest, 34.9% used a «uterus» positioning aid and 34.9% didn’t use anything. The newborns with neonatal nest obtained two points less in the score compared to the control group adjusted by covariables (β = -2, 95% CI -3.29, -0.77, p ‹ 0.002); those with a «uterus» positioning aid obtained one point less adjusted for the same variables (β = -1, 95% CI [-2.35, -0.23], p = 0.018). Conclusion: Implementing the routine use of positional body aids for preterm newborns in the NICU, especially a neonatal nest-type aid, helps to reduce anomalies in muscle tone and posture.

REFERENCES

1. Kihara H, Nakamura T. Nested and swaddled positioning support in the prone position facilitates sleep and heart rate stability in very low birth weight infants. Res Reports Neonatol. 2013; 3: 11-14.

2. Vaivre-Douret L, Golse B. Comparative effects of 2 positional supports on neurobehavioral and postural development in preterm neonates. J Perinat Neonatal Nurs. 2007; 21 (4): 323-330.

3. Waitzman KA. The importance of positioning the near-term infant for sleep, play and development. New Inf Nurs Rev. 2007; 7 (2): 76-81.

4. Ferrari F, Bertoncelli N, Gallo C, Roversi MF, Guerra MP, Ranzi A et al. Posture and movement in healthy preterm infants in supine position in and outside the nest. Arch Dis Child Fetal Neonatal Ed. 2007; 92 (5): F386-F390.

5. Monterosso L, Kristjanson LJ, Cole J, Evans SF. Effect of postural supports on neuromotor function in very preterm infants to term equivalent age. J Paediatr Child Health. 2003; 39 (3): 197-205.

6. Halverson K. The effects of positioning on premature infant development. Pediatrics CATs Paper 5. Disponible en: http://commons.pacificu.edu/otpeds/5. [Consultado 12/11/16]

7. Coughlin M, Lohman MB, Gibbins S. Reliability and effectiveness of an infant positioning assessment tool to standardize developmentally supportive positioning practices in the Neonatal Intensive Care Unit. New Inf Nurs Rev. 2010; 10 (2): 104-106.

8. Amiel-Tison C, Barrier G, Shnider SM, Levinson G, Hughes SC, Stefani SJ. A new neurologic and adaptive capacity scoring system for evaluating obstetric medications in full-term newborns. Anesthesiology. 1982; 56 (5): 340-350.

9. Gosselin J, Gahagan S, Amiel-Tison C. The Amiel-Tison Neurological Assessment at Term: conceptual and methodological continuity in the course of follow-up. Ment Retard Dev Disabil Res Rev. 2005; 11 (1): 34-51.