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Assisted Physical Exercise and Stress in Preterm Neonates
Subhash Chandra Shaw1, M Jeeva Sankar2, Anu Thukral1
1Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Assisted physical exercise in premature infants did not increase stress markers like salivary cortisol. Pain scores (PIPP) slightly increased during exercise but returned to baseline, suggesting safety for these vulnerable infants.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Physiology
Background:
- Premature infants experience physiological stress.
- Assisted physical exercise is a common intervention in neonatal care.
- Evaluating stress responses to interventions is crucial for infant well-being.
Purpose of the Study:
- To assess stress indicators in preterm infants undergoing assisted physical exercise.
- To compare salivary cortisol levels and pain scores before and after exercise sessions.
Main Methods:
- 25 infants born before 35 weeks' gestation participated.
- Assisted physical exercise was administered daily for 10-15 minutes.
- Salivary cortisol and Premature Infant Pain Profile (PIPP) scores were measured.
Main Results:
- Salivary cortisol showed no significant difference post-exercise compared to baseline.
- A slight decrease in salivary cortisol was observed 30 minutes after exercise (P=0.04).
- PIPP scores increased during and at the completion of exercise but were not sustained.
Conclusions:
- Assisted physical exercise appears safe and does not induce significant physiological stress in preterm infants.
- The intervention may not cause lasting stress responses, warranting further investigation.
Objective:
To evaluate the markers of stress before and after a session of assisted physical exercise in infants born before 35 weeks' gestation.
Methods:
25 infants born at 280/7 to 346/7 weeks were subjected to assisted physical exercise daily for about 10-15 min at one week of postnatal age or 33 weeks of post menstrual age, whichever was later. Primary outcome was salivary cortisol and secondary outcome was Premature infant pain profile (PIPP) score. Outcomes were measured, on day 5 (±1) of exercise.
Results:
There was no difference in salivary cortisol between baseline and immediately after (P=0.16), at 90 min (P=0.6) or 120 min (P=0.7) after exercise. Salivary cortisol was lower at 30 min after exercise as compared to baseline (mean difference -0.08 µg/dL; 95% CI -0.16 to -0.002; P=0.04). The median (IQR) PIPP score was significantly higher at 5 min into exercise (4 (3-6) vs 4 (3-5); P=0.04) and at completion of exercise 6 (4-8) vs 4 (3-5); P<0.01), as compared to baseline.
Conclusion:
Assisted physical exercise does not seem to result in stress in premature infants.
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