Margareth Gurgel de Castro Silva1, Marina Carvalho de Moraes Barros2, Úrsula Maria Lima Pessoa1, Ruth Guinsburg3. 1. Maternidade Escola Assis Chateaubriand, Fortaleza, CE, Brazil. 2. Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil. Electronic address: marinamoraesbarros@uol.com.br. 3. Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
Abstract
OBJECTIVE: To evaluate the effect of kangaroo-mother care (KMC) in preterm (PT) neurobehavior between 36 and 41 weeks post-conceptual age (PCA). METHOD: A prospective cohort of 61 preterm infants with gestational age (GA) of 28-32 w evaluated by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS), with 36-41 w PCA. Infants with clinical instability were excluded. They were analyzed in 2 groups: - Kangaroo (KAN): KMC for 7 or more days; Conventional (CON): did not receive KMC. Scores of the 13 NNNS variables were compared between groups and the effect of KMC in the scores of the variables of NNNS were evaluated by multiple linear regression, controlling for confounders. RESULTS: The KAN groups (n=24) and CON (n=37) were similar regarding main demographic and clinical maternal and neonatal characteristics. Mean GA was 30.3 w; and birth weight was 1170 g for both groups. PT of KAN group were admitted in KMC with PCA of 35.8 w (38.5 days of life) and remained with this care for 14.3 days. The NNNS was applied 13 days after the start of KMC. PT submitted to KMC showed higher quality of movements (KAN: 4.98 ± 0.53 vs CON: 4.53 ± 0.47; p=0.001) and lower scores on Signs of stress and abstinence (KAN: 0.03 ± 0.03 vs CON: 0.05 ± 0.03; p=0.001). Controlling for confounders, the KMC was associated with higher scores on the variables Attention, Quality of movements, and lower scores on Asymmetry and Signs of stress and abstinence. CONCLUSION: PT submitted to the KMC, compared to those non-submitted, have better neurobehavior performance between 36 and 41 weeks of post-conceptual age.
OBJECTIVE: To evaluate the effect of kangaroo-mother care (KMC) in preterm (PT) neurobehavior between 36 and 41 weeks post-conceptual age (PCA). METHOD: A prospective cohort of 61 preterm infants with gestational age (GA) of 28-32 w evaluated by the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS), with 36-41 w PCA. Infants with clinical instability were excluded. They were analyzed in 2 groups: - Kangaroo (KAN): KMC for 7 or more days; Conventional (CON): did not receive KMC. Scores of the 13 NNNS variables were compared between groups and the effect of KMC in the scores of the variables of NNNS were evaluated by multiple linear regression, controlling for confounders. RESULTS: The KAN groups (n=24) and CON (n=37) were similar regarding main demographic and clinical maternal and neonatal characteristics. Mean GA was 30.3 w; and birth weight was 1170 g for both groups. PT of KAN group were admitted in KMC with PCA of 35.8 w (38.5 days of life) and remained with this care for 14.3 days. The NNNS was applied 13 days after the start of KMC. PT submitted to KMC showed higher quality of movements (KAN: 4.98 ± 0.53 vs CON: 4.53 ± 0.47; p=0.001) and lower scores on Signs of stress and abstinence (KAN: 0.03 ± 0.03 vs CON: 0.05 ± 0.03; p=0.001). Controlling for confounders, the KMC was associated with higher scores on the variables Attention, Quality of movements, and lower scores on Asymmetry and Signs of stress and abstinence. CONCLUSION: PT submitted to the KMC, compared to those non-submitted, have better neurobehavior performance between 36 and 41 weeks of post-conceptual age.