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Incidence of Intermittent Hypoxemia Increases during Clinical Care and Parental Touch in Extremely Preterm Infants

Stephanie Margarete Mueller1, Benjamin W Ackermann2, Sven Martin1

  • 1Haptic Research Lab, Paul-Flechsig-Institute for Brain Research and Neuropathology, University of Leipzig, Leipzig, Germany.

Neonatology
|December 12, 2022
PubMed

Insights

Intermittent hypoxemia (IH) in extremely preterm infants is reduced by skin-to-skin contact and parental care, but surprisingly increased by incubator touch. Further research is needed to optimize handling strategies.

Area of Science:

  • Neonatology
  • Pediatric Critical Care
  • Developmental Pediatrics

Background:

  • Intermittent hypoxemia (IH) in extremely preterm infants is linked to adverse developmental outcomes, disability, and mortality.
  • Optimizing care to minimize IH is crucial for improving infant health and long-term prognosis.

Purpose of the Study:

  • To quantify the impact of various hands-on medical and parental interventions on the incidence of IH in extremely preterm infants.
  • To identify care practices that may exacerbate or alleviate IH episodes.

Main Methods:

  • Observational study with intraindividual comparisons of extremely preterm infants (gestational age ≤28 weeks).
  • Recorded blood oxygen saturation (SpO2) and used time-lapse video to analyze IH (SpO2 <80% for ≥10 s).
  • Compared IH incidence across different care conditions: nursing and medical care (NMC), parental care, skin-to-skin contact (SSC), incubator touch, physiotherapy, and rest.

Main Results:

  • The highest proportion of time with IH occurred during NMC (2.49%) and incubator touch (1.32%).
  • Skin-to-skin contact (0.74%) and parental care (0.67%) showed the lowest incidence of IH.
  • IH frequency per hour was highest during NMC and lowest during SSC (p < 0.001).

Conclusions:

  • Skin-to-skin contact and parental care are associated with significantly lower rates of intermittent hypoxemia.
  • Incubator touch, intended to be soothing, was surprisingly associated with a higher incidence of IH.
  • Further research is required to understand infant responses to touch and develop effective handling strategies to minimize IH.
Abstract

Keywords:
Apnea of prematurityHypoxiaOxygen desaturationRespiratory functionSkin to skin

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