Simulated kangaroo care in very preterm infants does not reduce physiological instability: the COSYBABY randomised...

Area of Science:

• Neonatal Medicine
• Pediatric Critical Care
• Physiological Monitoring

Background:

• Very preterm infants often experience physiological instability, including apnoea, oxygen desaturation, and bradycardia, due to immature systems.
• Kangaroo care (parental skin-to-skin contact) may improve physiological stability, but continuous parental presence is not always feasible.
• The BABYBE SYSTEM® is a medical device developed to mimic kangaroo care for preterm infants.

Purpose of the Study:

• To evaluate the efficacy of the BABYBE mattress in reducing episodes of physiological instability, specifically apnoea, in very preterm infants.
• To compare the incidence of apnoeic episodes when the BABYBE mattress was active versus inactive.

Main Methods:

• A randomized cross-over trial involving 23 infants born before 32 weeks' gestation.
• Infants were monitored for five consecutive days, with alternating 12-hour periods of the BABYBE mattress being switched on or off.
• Physiological instability episodes were identified from vital signs monitor recordings and compared with clinical notes; generalized estimating equations were used for analysis.

Main Results:

• No statistically significant difference was found in the number of apnoeic episodes between the BABYBE mattress on and off conditions (p=0.09).
• A substantial discrepancy was observed between apnoeic episodes detected by vital signs recordings (1,157) and those documented in clinical notes (27).
• The trial included 23 infants born before 32 weeks' gestation.

Conclusions:

• The BABYBE mattress did not demonstrate a significant benefit in improving the physiological stability of preterm infants during the study period.
• The study confirms the significant under-recognition of apnoeic episodes in routine clinical documentation.
• Continuous assessment of electronic vital signs recordings is crucial for a comprehensive understanding of physiological stability in preterm neonates.