Oxytocin in prematurely born infants and their parents - A systematic review with clinical implications
Ulrike Schneider-Schmid1, André Morgado2, Christine Heim3
1Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Medical Psychology, Berlin 10117, Germany.
Insights
Oxytocin (OT) levels increase with bonding interventions like skin contact for preterm infants and parents. These interventions reduce stress and support attachment, benefiting both mother and child.
Area of Science:
- Neuroscience
- Neonatology
- Developmental Psychology
Background:
- Oxytocin (OT) plays a key role in mother-child bonding and may offer neuroprotection.
- Preterm infants (≤37 weeks) are at high risk and often separated from parents, missing crucial in-utero OT development.
- Maternal and infant OT concentrations are lower in preterm births compared to full-term pregnancies.
Purpose of the Study:
- To review studies on oxytocin concentrations in preterm infants and their parents.
- To investigate factors influencing oxytocin secretion in this population.
- To assess the impact of bonding interventions on oxytocin levels.
Main Methods:
- Systematic literature search using PRISMA guidelines and keywords like "oxytocin", "infants", "prematurely".
- Databases searched: PubMed, ScienceDirect, Google Scholar, PsycInfo.
- Narrative synthesis and partial meta-analysis due to heterogeneity in 15 selected studies.
Main Results:
- Oxytocin quantification methods were highly varied.
- Limited sample sizes (mean n=31) with OT primarily measured in infant saliva.
- Intervention studies showed a positive link between OT levels and physical contact, stress reduction, and attachment.
- Meta-analysis revealed a medium effect size (SMD = 0.40, p=0.002) for bonding interventions on maternal oxytocin.
Conclusions:
- Despite methodological limitations, results suggest bonding interventions increase oxytocin in preterm infants and parents.
- These interventions offer anxiolytic and stress-reducing benefits, supporting Kangaroo care.
- Future research needs longitudinal designs, control groups, and standardized methods for reliability.
Introduction:
The neuropeptide oxytocin (OT) is considered an important regulatory factor in mother-child bonding after birth. It is also thought to have neuroprotective effects, which could be particularly important for preterm born (≤ 37 weeks) infants, who are considered a high-risk group for several health issues. They are born when their own and their mother's OT-concentrations have not yet reached their maximum during pregnancy and often require neonatal intensive care, separating them from their parents. This review aims to identify studies on OT-concentration in preterm infants and their parents as well as to investigate possible influences on their OT-secretion.
Methods:
The systematic literature search was conducted according to PRISMA guidelines, using the keywords "oxytocin", "infants", "prematurely" and synonyms in the PubMed, ScienceDirect, Google Scholar and PsycInfo databases. 15 publications met the criteria. As the studies were very heterogeneous in terms of the methods applied for the analysis of oxytocin concentration, a narrative synthesis and just a partial meta-analysis was performed.
Results:
The quantification methods of OT were heterogeneous, the reported maternal values ranged from 1 to 4000 pg/ml. The sample sizes were limited (mean n = 31 across all studies) and OT was mostly measured in infant saliva. In the intervention studies, a consistent positive relationship was found between OT-concentration and physical contact, stress reduction and attachment behavior. A meta-analysis was performed for the effect size of bonding interventions like SSC on OT in maternal saliva, revealing a medium effect size (SMD = 0.40, p = 0.002).
Discussion:
Despite the variance in methods and a certain risk of bias which limits the reliability of the studies, the overall results suggest an increase in oxytocin concentrations in response to bonding interventions like skin contact in preterm infants and their parents. Both appear to benefit from these anxiolytic and stress-reducing measures, supporting the clinical application of Kangaroo care in preterm infants. Methodological issues related to OT assessment in different body fluids of prematurely born infants are critically discussed. Future studies, applying an open-science approach, should focus on longitudinal designs, inclusion of control groups and confounding variables to ensure reliability and comparability.
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