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Retinopathy of prematurity screening, stress related responses, the role of nesting
1Department of Neonatology, National Maternity Hospital, Dublin, Ireland.
Insights
Retinopathy of prematurity (ROP) screening causes distress in preterm infants. Nesting significantly reduces discomfort during ROP screening, offering a more optimal examination schedule.
Area of Science:
- Neonatal care
- Ophthalmology
- Developmental pediatrics
Background:
- Retinopathy of prematurity (ROP) screening is a critical procedure for preterm infants.
- ROP screening can induce significant distress in vulnerable newborns.
Purpose of the Study:
- To assess the distress levels experienced by preterm infants during ROP screening.
- To evaluate the effectiveness of nesting as an intervention to mitigate this distress.
Main Methods:
- A prospective study involving 38 preterm infants, divided into a nesting intervention group and a control group.
- Observed crying, neurobehavioral activity, heart rate, and oxygen saturation before, during, and after ROP examination.
- Utilized video recording and an Oxypleth monitor for data collection.
Main Results:
- ROP screening led to increased neurobehavioral activity and crying in all infants.
- Nesting significantly reduced movement activity and crying compared to the control group (p < 0.01).
- No statistically significant differences were observed in heart rate or oxygen saturation between groups.
Conclusions:
- ROP screening is a distressing procedure for preterm infants.
- Nesting is an effective method to significantly reduce infant distress during ROP screening.
- Findings support the implementation of nesting in ROP examination protocols to improve infant comfort.
Aims/Background:
In a prospective study the degree of distress caused by retinopathy of prematurity (ROP) screening in a cohort of preterm infants was assessed and the modifying effects of nesting in reducing their discomfort was evaluated.
Methods:
38 preterm infants were included in the study. 19 infants were placed in a nest with boundaries (intervention group) and 19 infants were placed on a cot blanket (control group). Observations were made 2 minutes before, throughout, and 2 minutes after ROP examination. The factors observed were crying responses, neurobehavioural activity, and physiological changes (heart rate, oxygen saturation). Recordings were made using a video camera for crying and neurobehavioural activity and an Oxypleth monitor for heart rate and oxygen saturation.
Results:
During ROP screening, the total group of 38 infants (nested and non-nested combined) displayed increased neurobehavioural activity (p < 0.01) and crying (p < 0.01). The increased activity and crying coincided with the invasive part of the procedure. The distress caused by ROP screening was significantly less for the nested group compared with the non-nested group for both movement activity (p < 0.01) and crying (p < 0.01). The physiological data, heart rate, and oxygen saturation were not statistically significant.
Conclusion:
ROP screening is distressing for preterm infants. Nesting can significantly reduce this discomfort. The findings in this study are of value in designing more optimal ROP examination schedules for infants.