Influência da duração do contato pele a pele sobre o sono e parâmetros fisiológicos de recém-nascidos pré-termo

• Ano de defesa: 2020
• Autor(a) principal: Pinto, Claudia Machado Alves [UNIFESP]
• Orientador(a): Avelar, Ariane Ferreira Machado [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/48912/001300002mr2j
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Enfermagem neonatal; Método canguru; Recém-nascido prematuro; Sono; Sinais Vitais
• Palavras-chave em Inglês: Neonatal nursing; Kangaroo mMethod; Premature newborn; Sleep; Vital signs
• Link de acesso: https://hdl.handle.net/11600/64417; https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=9918379

Introduction: Improving the sleep-wake pattern and stabilizing the vital signs of preterm newborns (PTNB) are benefits related to skin-to-skin contact with their mother or father, with a positive impact on brain development, maturation and repair , behavioral, cognitive and motor of the newborn. However, the duration of skin-to-skin contact is still not clearly established in order to achieve the expected positive results during hospitalization and discharge of PTNB. Objective: To investigate the influence of the duration of skin-to-skin contact on sleep and physiological parameters of preterm newborns and the maternal and neonatal characteristics that may interfere with the duration of this contact. Casuistry and method: Cross-sectional study, developed with preterm newborns, weighing less than 2,000 grams and able to perform skin-to-skin contact (CPP) at the Conventional Neonatal Intermediate Care Unit of a public maternity hospital in the Western Brazilian Amazon. The convenience sample consisted of 36 PTNB and 30 mothers. Data collection took place from April to October 2018. Sociodemographic, reproductive and obstetric maternal, biological and neonatal vitality variables, those related to skin-to-skin contact and their duration, physiological and behavioral parameters were investigated. The physiological parameters of newborns (NB) were recorded before, during and after a single session of skin-to-skin contact, and the mother's temperature was recorded before and after. The behavioral responses presented by the newborns during the CPP were filmed in real time, and the predominant state of the behavior was recorded at the end of each 10-second recording period. The differentiation of the sleep-wake states of PTNBs was performed based on the definitions of an accepted observational biobehavioral assessment method and classified as sleep, wakefulness and transition. Results: Skin-to-skin contact occurred for a median time of 2.12 hours (1st quartile: 1.65; 3rd quartile: 2.99), with newborns between 26 and 31 weeks of gestational age and weight between 980 and 2,000 grams at birth. Most mothers (55.6%) remained in CPP for more than 2 hours. Statistically significant differences were identified in the respiratory rate of the PTNB and maternal axillary temperature between the values before and after the CPP and the neonatal heart rate before the end of the CPP (p⦤0.05). With regard to behavior, the duration of CPP did not significantly influence the sleep time of PTNB, but it was possible to observe that NBs who stayed in contact longer spent more time sleeping. Conclusion: our study was unable to identify the effect of CPP duration on sleep in this sample of preterm newborns. Monitoring the behavioral state for a longer period can provide significant insights. As for the physiological parameters, the CPP promoted an increase in the neonatal respiratory rate and maternal axillary temperature after contact and the heart rate of the newborns at the end of the contact.