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Cobedding and recovery time after heel lance in preterm twins: results of a randomized trial
Marsha L Campbell-Yeo1, C Celeste Johnston, K S Joseph
1Women’s and Newborn Health Program, IWK Health Centre, Halifax, Nova Scotia, Canada. marsha.campbellyeo@iwk.nshealth.ca
Insights
Cobedding preterm twins improved physiological recovery after heel lance but did not reduce pain scores. This practice offers tactile, olfactory, and auditory stimulation, potentially aiding recovery in neonates.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Pain management
Background:
- Preterm infants require specialized care to manage pain and promote recovery.
- Cobedding, a practice involving shared incubator or crib care for twins, offers sensory stimulation.
- The impact of cobedding on pain reactivity and recovery in preterm twins is not fully understood.
Purpose of the Study:
- To evaluate the effect of cobedding on pain reactivity in preterm twin neonates.
- To assess the impact of cobedding on the time to return to physiologic baseline parameters after a painful stimulus.
- To compare pain scores and recovery times between cobedded and separately housed preterm twins.
Main Methods:
- A randomized trial involving 67 sets of stable preterm twins (28-36 weeks gestational age) was conducted.
- Twins were assigned to either a cobedding group (shared incubator/crib) or a standard care group (separate incubators/cribs).
- Pain response (Premature Infant Pain Profile [PIPP]) and recovery time were measured and compared, adjusting for twin nonindependence.
Main Results:
- No significant differences in maternal or infant characteristics were observed between groups, except for specific baseline measures.
- Mean PIPP scores did not differ at 30, 60, or 120 seconds; however, scores were higher in the cobedding group at 90 seconds (P = .04).
- Recovery time was significantly shorter in the cobedding group (75.6 seconds) compared to the standard care group (142.1 seconds, P = .001).
Conclusions:
- Cobedding significantly enhanced the physiological recovery of preterm twins following heel lance.
- While cobedding did not result in lower pain scores, it accelerated the return to baseline physiological parameters.
- No adverse events were associated with the cobedding intervention, suggesting it is a safe practice.
Objectives:
Cobedding of preterm twin infants provides tactile, olfactory, and auditory stimulation and may affect pain reactivity. We carried out a randomized trial to assess the effect of cobedding on pain reactivity and recovery in preterm twin neonates.
Methods:
Stable preterm twins (n = 67 sets) between 28 and 36 weeks of gestational age were randomly assigned to a cobedding group (cared for in the same incubator or crib) or a standard care group (cared for in separate incubators or cribs). Pain response (determined by the Premature Infant Pain Profile [PIPP]) and time to return to physiologic baseline parameters were compared between groups with adjustment for the nonindependence of twin infants.
Results:
Maternal and infant characteristics were not significantly different between twin infants in the cobedding and standard care groups except for 5-minute Apgar <7 and postnatal age and corrected gestational age on the day of the heel lance. Mean PIPP scores were not different between groups at 30, 60, or 120 seconds. At 90 seconds, mean PIPP scores were higher in the cobedding group (6.0 vs 5.0, P = .04). Recovery time was shorter in the cobedding group compared with the standard care group, (mean = 75.6 seconds versus 142.1 seconds, P = .001). No significant adverse events were associated with cobedding. Adjustment for nonindependence between twins and differences in baseline characteristics did not change the results.
Conclusions:
Cobedding enhanced the physiologic recovery of preterm twins undergoing heel lance, but did not lead to lower pain scores.
