Background: Skin-to-skin care (the intermittent placement of a diaper-clad infant on a caretaker’s chest to enhance attachment and parental self-esteem), is a common occurrence in most newborn intensive care units (NICUs). Skin-to-skin care has been shown to be safe for preterm infants, independent of respiratory support. Heart rate variability (HRV), the temporal variation between consecutive heart beats, provides a measure of the balance between sympathetic and parasympathetic nervous system. HRV increases with gestational age and changes in HRV are associated with various clinical conditions. Therefore, measuring heart rate variability may be useful in capturing clinical dynamic changes in autonomic regulation in response to skin-to-skin care. Objective: To measure heart rate variability, we captured the standard deviation of the normal-to-normal interval (SDNN), the root mean squared of successive differences of the normal-to-normal interval (RMSDD), and the standard deviation of deceleration (SDDec), at three time points (pre, during and post skin-to-skin care).
Methods: 10 preterm infants requiring respiratory support will be enrolled in this prospective crossover study. Infants will act as their own controls. Heart rate variability data is collected before, during and after skin-to-skin sessions with a parent. Anticipated
Results: We expect skin-to-skin care to be associated with a more mature pattern of parasympathetic activity, as measured by HRV; specifically the SDNN, RMSDD, and SDDec will decrease during skin-to-skin care regardless of the type of respiratory support. Next Steps: Complete participant enrollment (currently 8 preterm infants have been enrolled), data collection and statistical analysis.
Swieter, Erin; Julia Stephen; Jessie R. Maxwell; and Kristi Watterberg. "Investigating the Impact of Skin to Skin Care on Preterm Infant Heart Rate Variability." (2022). https://digitalrepository.unm.edu/hsc_2022_pediatric_research/23