The Effect Of Kangaroo Mother Care On Brain Function,Neurobehavior And Repeated Procedural Pain In Premature Infants

Objective:To explore the effect of Kangaroo mother care（KMC）on brain function,neurobehavior and repeated procedural pain in premature infants,with a view to providing basis and reference for improving prognosis and relieving repeated procedural pain of premature infants in the clinical work.Methods:Totally 76 preterm infants（birth gestational age 31-33⁺66 weeks,birth weight≥1500g）were admitted to the NICU in Affiliated Hospital of Southwest Medical University between July 2018 and August 2019 were divided into a control group（n=38）and an intervention group（n=38）according to random number generated by the Excel.The control group received routine care,while the intervention group received at least 1 hour of KMC daily on the basis of routine care.In the case of observable pain response of heel stick,KMC would be applied 30 minutes before the heel stick until the end of the operation for a total of at least 1 hour of KMC.aEEG monitoring and NBNA measurement were performed on day 1,day 7 and day 14 after enrollment to compare the differences in aEEG scores,the proportion of background activity continuity and mature sleep-wake cycle,the amplitude and bandwidth of the upper and lower borders of the narrow band,and NBNA scores between the two groups.At the same time,PIPP scores,HR,SPO₂,and r_cSO₂ of the three phases（baseline,blood collection phase,and recovery phase）of four routine heel sticks were compared between the two groups within 14 days after enrollment.For the first heel stick,preterm infants in each group received routine care,and for the next three heel sticks,the corresponding intervention was performed according to the assigned group.SPSS20.0 software was used for comprehensive analysis of the data.The t test,non-parametric test and chi square test were used for inter-group comparison.P<0.05 was considered statistically significant.Results:1.On the 7th day after enrollment,the sleep-wake cycle score and total aEEG score of the intervention group were higher than those of the control group,and the differences were statistically significant（P<0.05）.On the14th day after enrollment,the scores of sleep-wake cycle,bandwidth and total aEEG of the intervention group were higher than those of the control group,and differences were statistically significant（P<0.05）.2.On the 7th day and 14th day after enrollment,the two groups had no significant difference on the proportion of background activity continuity（P>0.05）,but had significant difference on the proportion of mature sleep-wake cycle（P<0.05）.3.On the 7th day after enrollment,the bandwidth of the intervention group was significantly narrower than that of the control group（P<0.05）.On the14th day after enrollment,the lower boundary amplitude of the intervention group was significantly higher than that of the control group（P<0.05）,and the bandwidth was significantly narrower than that of the control group（P<0.05）.4.On the 7th day after enrollment,the scores of behavioral ability,passive muscle tone,and total NBNA of the intervention group were higher than those of the control group,and the differences were statistically significant（P<0.05）.On the 14th day after enrollment,the scores of behavioral ability,passive muscle tone,active muscle tone,and total NBNA of the intervention group were higher than those of the control group,and the differences were statistically significant（P<0.05）.5.For the first heel stick,there were no significant differences in PIPP score,HR,SPO₂,and r_cSO₂ between the two groups（P>0.05）.PIPP score and HR were significantly lower,the SPO₂ and r_cSO₂ were significantly higher of the intervention group than those of the control group during blood collection and recovery phases of the repeated three heel sticks（P<0.05）.Conclusion:1.KMC can promote the development of brain function of premature infants.2.KMC can accelerate the maturation of aEEG background activity of premature infants.3.KMC can improve the neurobehavior performance of premature infants.4.KMC can effectively relieve repeated procedural pain in premature infants,and may reduce the adverse effects of painful stimulation on brain function development.