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Updated: Aug 5, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Release of Oxytocin and Cortisol Is Associated With Neurobehavioral Patterns in Premature Infants
Insights
Skin-to-skin contact with parents influences preterm infant neurobehavioral functioning. Infant oxytocin and cortisol levels correlate with stress and self-regulation, with notable differences between maternal and paternal contact.
Area of Science:
- Neonatal care
- Developmental psychology
- Endocrinology
Background:
- Preterm infants face neurodevelopmental challenges.
- Skin-to-skin contact (SSC) is a vital intervention in neonatal intensive care units (NICUs).
- Parental hormones, like oxytocin and cortisol, may influence infant outcomes during SSC.
Purpose of the Study:
- To investigate the association between salivary oxytocin and cortisol levels in parents and preterm infants.
- To explore the relationship between these hormone levels and infant neurobehavioral functioning post-SSC.
- To identify potential differences in hormonal responses and neurobehavioral outcomes based on maternal versus paternal SSC.
Main Methods:
- Secondary analysis of a randomized crossover study involving 28 preterm infants and their parents.
- Collection of 108 infant saliva samples 45 minutes after SSC for oxytocin and cortisol analysis.
- Assessment of infant neurobehavioral functioning using the NICU Network Neurobehavioral Scale (NNNS) and linear regression analysis.
Main Results:
- Infant oxytocin levels showed a negative correlation with Stress and Excitability scores following maternal SSC.
- Higher infant oxytocin levels were positively associated with Self-Regulatory scores after maternal SSC.
- Infant cortisol levels correlated positively with Stress, Excitability, and Asymmetrical Reflexes scores after maternal SSC.
- A negative relationship was observed between infant cortisol and Stress scores following paternal SSC.
Conclusions:
- Salivary oxytocin serves as a significant biomarker for infant neurobehavioral functioning.
- The study highlights distinct oxytocin responses in infants following SSC with mothers versus fathers.
- Findings suggest that parental SSC, mediated by hormonal changes, can positively impact preterm infant neurobehavioral development.
Objective:
To examine relationships among salivary oxytocin and cortisol levels in parents and preterm infants and neurobehavioral functioning in preterm infants after skin-to-skin contact.
Design:
A secondary analysis of a randomized crossover study.
Setting:
NICU.
Participants:
Twenty-eight stable premature infants and their mothers and fathers.
Methods:
Participating infants contributed 108 saliva samples that we collected 45 minutes after skin-to-skin contact and tested for oxytocin and cortisol. We randomized data collection by whether the infant was held first by the mother or by the father. We conducted linear regression to test if summary scores on the NICU Network Neurobehavioral Scale were associated with salivary oxytocin and cortisol levels.
Results:
We found a significant negative relationship between infant oxytocin levels and the Stress scores (b = -0.07, p < .01) and the Excitability scores (b = -1.12, p = .04) among infants held skin-to-skin with their mothers. We found a significant positive relationship between infant oxytocin levels and the Self-Regulatory scores (b = 0.38, p = .05) among infants held skin-to-skin with their mothers. We found a significant positive relationship between infant cortisol level and the Stress scores (b = 0.05, p = .04), Excitability scores (b = 1.06, p = 0.05), and Asymmetrical Reflexes scores (b = 1.21, p = .03) among infants held skin-to-skin with their mothers. We only found a negative significant relationship between infant cortisol levels and the Stress scores (b = -0.03, p = .04) among infants held skin-to-skin with their fathers.
Conclusion:
We found that oxytocin is an important biomarker that may improve infant neurobehavioral functioning. The data showed a difference in oxytocin responses after skin-to-skin contact with mothers compared to fathers.
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