Stress Responses of Neonates Related to Maternal Characteristics
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To investigate the pre- and post-heelstick stress response patterns of infants and to identify related maternal factors. Materials and Methods: Fifty-two mothers and their 57 infants were studied. Stress response patterns in neonates were collected by measurements of pulse rate, oxygen saturation, and salivary cortisol. Maternal demographic factors and awakening saliva were collected. Results: Median level of pulse rate of infant increased from 132.1 to 140.4 beats per minute and salivary cortisol was elevated from 0.41 μg/dL to 0.70 μg/dL during the periods of discomfort, while oxygen saturation decreased from 97% to 95%. Infant’s pulse rate change was negatively correlated with gestational age (GA) (r = - 0.37, p < 0.05), whereas the change of infants’ salivary cortisol was correlated positively with maternal age (r = 0.29, p < 0.05). GA was the only independently significant predictor of pulse rate responses (R^2 = 0.15, p < 0.05). Influence of maternal age on infants’ salivary cortisol changes (R^2 = 0.09, p < 0.05) was observed in a stepwise multiple regression. Conclusion: These findings suggest that maternal age and gestational period can be influential factors for stress responses in infants. Therefore, it would be important to consider the demographic characteristics of mother-infant pairs to evaluate these influential factors.
Abstract
Purpose: To investigate the pre- and post-heelstick stress response patterns of infants and to identify related maternal factors. Materials and Methods: Fifty-two mothers and their 57 infants were studied. Stress response patterns in neonates were collected by measurements of pulse rate, oxygen saturation, and salivary cortisol. Maternal demographic factors and awakening saliva were collected. Results: Median level of pulse rate of infant increased from 132.1 to 140.4 beats per minute and salivary cortisol was elevated from 0.41 μg/dL to 0.70 μg/dL during the periods of discomfort, while oxygen saturation decreased from 97% to 95%. Infant’s pulse rate change was negatively correlated with gestational age (GA) (r = - 0.37, p < 0.05), whereas the change of infants’ salivary cortisol was correlated positively with maternal age (r = 0.29, p < 0.05). GA was the only independently significant predictor of pulse rate responses (R^2 = 0.15, p < 0.05). Influence of maternal age on infants’ salivary cortisol changes (R^2 = 0.09, p < 0.05) was observed in a stepwise multiple regression. Conclusion: These findings suggest that maternal age and gestational period can be influential factors for stress responses in infants. Therefore, it would be important to consider the demographic characteristics of mother-infant pairs to evaluate these influential factors.
참고문헌 (23)
- Emack J, "Chronic maternal stress affects growth, behaviour and hypothalamo-pituitary-adrenal function in juvenile offspring", Horm Behav, 54, pp.514~520 (2008)
- Weinstock M, "Alterations induced by gestational stress in brain morphology and behaviour of the offspring", Prog Neurobiol, 65, pp.427~451 (2001)
- Pineles BL, "Sensitization of cardiac responses to pain in preterm infants", Neonatology, 91, pp.190~195 (2007)
- Gibbins S, "Comparison of pain responses in infants of different gestational ages", Neonatology, 93, pp.10~18 (2008)
- Schäffer L, "Blunted stress response in small for gestational age neonates", Pediatr Res, 65, pp.231~235 (2009)
- Gunnar MR, "Cortisol and behavioral responses to repeated stressors in the human newborn", Dev Psychobiol, 24, pp.487~505 (1991)
- Mörelius E, "Salivary cortisol response in mother-infant dyads at high psychosocial risk", Child Care Health Dev, 33, pp.128~136 (2007)
- Herrington CJ, "Salivary cortisol as indicators of pain in preterm infants: a pilot study", Clin Nurs Res, 13, pp.53~68 (2004)
- Lewis M, "Stability and change in cortisol and behavioral response to stress during the first 18 months of life", Dev Psychobiol, 28, pp.419~428 (1995)
- Azar R, "The association of major depression, conduct disorder, and maternal overcontrol with a failure to show a cortisol buffered response in 4-month-old infants of teenage mothers", Biol Psychiatry, 62, pp.573~579 (2007)
- Bugental DB, "Hormonal sensitivity of preterm versus full-term infants to the effects of maternal depression", Infant Behav Dev, 31, pp.51~61 (2008)
- Mörelius E, "Salivary cortisol and mood and pain profiles during skin-to-skin care for an unselected group of mothers and infants in neonatal intensive care", Pediatrics, 116, pp.1105~1113 (2005)
- Nelson N, "Neonatal salivary cortisol in response to heelstick: method modifications enable analysis of low concentrations and small sample volumes", Scand J Clin Lab Invest, 61, pp.287~291 (2001)
- Klug I, "Cortisol and 17-hydroxyprogesterone levels in saliva of healthy neonates: normative data and relation to body mass index, arterial cord blood pH and time of sampling after birth", Biol Neonate, 78, pp.22~26 (2000)
- Ayoubi JM, "Perinatal factors affecting survival and survival without disability of extreme premature infants at two years of age", Eur J Obstet Gynecol Reprod Biol, 105, pp.124~131 (2002)
- Murdoch DR, "Handling during neonatal intensive care", Arch Dis Child, 59, pp.957~961 (1984)
- Gibbins S, "Pain behaviours in Extremely Low Gestational Age infants", Early Hum Dev, 84, pp.451~458 (2008)
- Mantagos S, "A simple stress test for the evaluation of hypothalami-pituitary-adrenal axis during the first 6 months of life", J Clin Endocrinol Metab, 72, pp.214~216 (1991)
- McCubbin JA, "Prenatal maternal stress hormones, risk for hypertension, and the neonatal pain response: Comment on France et al., Maternal family history of hypertension attenuates neonatal pain response", Pain, 142, pp.173~174 (2009)
- Gitau R, "Fetal exposure to maternal cortisol", Lancet, 352, pp.707~708 (1998)
- Egliston KA, "Stress in pregnancy and infant HPA axis function: conceptual and methodological issues relating to the use of salivary cortisol as an outcome measure", Psychoneuroendocrinology, 32, pp.1~13 (2007)
- Pittard WB 3rd, "Associations between maternal age and infant health outcomes among Medicaid-insured infants in South Carolina: mediating effects of socioeconomic factors", Pediatrics, 122, pp.e100~e106 (2008)
- Gage TB, "Maternal age and infant mortality: a test of the Wilcox-Russell hypothesis", Am J Epidemiol, 169, pp.294~303 (2009)