The overall premise is that healthy fullterm newborn infants are more vulnerable than is generally thought during their physiologically demanding intrauterine-extrauterine adaptation. The broad longterm objective of this research is to determine which of the many accepted variations in postbirth care will best assist healthy and vulnerable fullterm infants, and ultimately many low-birth-weight infants, to successfully complete the intrauterine-extrauterine transition, thereby improving their chances for subsequent healthy growth and development.
The specific aim of this controlled clinical trial is to determine the effect on extrauterine adaptation of self-regulatory (SR) individualized nursing care. The health-relatedness of the project is that the treatment is designed to minimize crying and maximize regular respirations, in order to prevent shunts of venous blood through the foramen ovale (OF), relative systemic hypoxemia, and delayed closure of the ductus arteriosus (DA). The dependent variable, extrauterine adaptation, will be measured by DA and OF status, vital signs, behavior, weight curve, and first feeding ability. The sample will be 260 infants healthy enough to be admitted to the newborn nursery. Informed parental consent will be obtained. Two vulnerable groups will be included: healthy preterm infants < 37 week gestation and cesarean section infants. Infants of diabetic or drug-addicted mothers or infants small or large for gestation or born under general anesthesia will be excluded. All infants are routinely with their mothers if possible Hours 0-1 postbirth. At nursery admission Hour 1, infants will be randomly assigned, using the minimization technique, to the SR or Nursery Routine Group. SR care, given Hours 1-7, includes holding; cuddling; rocking; carrying; interacting verbally; making eye contact; allowing sleep; and offering a pacifier when the infant is mouthing, rooting, or fussing before feedings can begin. These data will be collected Hours 1-7 and 22-23: blood pressure and heart rate (DINAMAP), respiratory rate and behavioral state every 15 minutes; axillary temperature every hour; and hourly totals for cry time and gross motor activity. At Hours 6 and 22, infants will be weighed on a gram scale, and behavioral organization (Brazelton scale) will be assessed. Before the first Brazelton, and before and after the second, OF and DA status will be assessed by color and pulsed Doppler echo-cardiography. The hypotheses are that the dependent measures will favor the SR Group.
| Chiu, Sheau-Huey; Anderson, Gene Cranston (2009) Effect of early skin-to-skin contact on mother-preterm infant interaction through 18 months: randomized controlled trial. Int J Nurs Stud 46:1168-80 |
| Hake-Brooks, Sara J; Anderson, Gene Cranston (2008) Kangaroo care and breastfeeding of mother-preterm infant dyads 0-18 months: a randomized, controlled trial. Neonatal Netw 27:151-9 |
| Chiu, Sheau-Huey; Anderson, Gene Cranston; Burkhammer, Maria D (2005) Newborn temperature during skin-to-skin breastfeeding in couples having breastfeeding difficulties. Birth 32:115-21 |
| Anderson, Gene Cranston; Radjenovic, Doreen; Chiu, Sheau-Huey et al. (2004) Development of an observational instrument to measure mother-infant separation post birth. J Nurs Meas 12:215-34 |
| Swinth, Joan Y; Anderson, Gene Cranston; Hadeed, Anthony J (2003) Kangaroo (skin-to-skin) care with a preterm infant before, during, and after mechanical ventilation. Neonatal Netw 22:33-8 |
| Anderson, Gene Cranston; Chiu, Sheau-Huey; Dombrowski, Mary Alice et al. (2003) Mother-newborn contact in a randomized trial of kangaroo (skin-to-skin) care. J Obstet Gynecol Neonatal Nurs 32:604-11 |
| Anderson, G C; Dombrowski, M A; Swinth, J Y (2001) Kangaroo care: not just for stable preemies anymore. Reflect Nurs Leadersh 27:32-4, 45 |
| Dombrowski, M A; Anderson, G C; Santori, C et al. (2001) Kangaroo (skin-to-skin) care with a postpartum woman who felt depressed. MCN Am J Matern Child Nurs 26:214-6 |
| Swinth, J Y; Nelson, L E; Hadeed, A et al. (2000) Shared kangaroo care for triplets. MCN Am J Matern Child Nurs 25:214-6 |
| Dombrowski, M A; Anderson, G C; Santori, C et al. (2000) Kangaroo skin-to-skin care for premature twins and their adolescent parents. MCN Am J Matern Child Nurs 25:92-4 |
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