Mother-infant separation, as a result of hospitalization, leads to stress and anxiety for both parent and infant, lowers feelings of maternal competency and corrupts bonding process. Kangaroo Care (KC), is as a widespread procedure in which the naked newborn is placed on the parent's bare chest. KC is known to enhance neonatal outcome by improving temperature regulation, cardiorespiratory stability or psychomotor development. It also promotes mother-infant interactions and enhances parental psychological well-being. Heart rate variability (HRV) analysis is a non-invasive tool able to consider autonomic nervous system activity. Previous studies have shown that pleasant feelings are associated with an increase of high frequencies variations index (HFnu index) reflecting a prevalence of parasympathetic activity. This one can be assess by a new monitor called NIPΣ (Neonatal index of parasympathetic activity) in newborns and ANI (Analgesic nociception index) in adults can provide a comfort index by quantifying the parasympathetic tone. The investigators hypothesize that kangaroo care could induce an autonomic co-regulation between newborn and parent by increasing parasympathetic activity. The study will involve 40 preterm or term newborns and their parent, performing a one hour kangaroo care session in intensive unit and neonatal intensive care unit from hospital of Saint-Etienne (France).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
30
The ECG signal, respiration rate, SpO2 and NIPΣ or ANI are recorded simultaneously on a computer with a capture card. The other indices of HRV will be analyzed offline: SDNN (standard deviation of all NN intervals), pNN30 (NN30 count divided by the total number of all NN intervals), pNN50 (NN50 count divided by the total number of all NN intervals), RMSSD (quadratic mean of successive R-R intervals), SD1 (standard deviation), SD2 (standard deviation), LF (low frequencies), HF (high frequencies), VLF (very low frequencies), SDANN (standard deviation of the averages of NN intervals in all 5 min segments of the entire recording), ratio LF/ HF, Ptot, Poincaré plot (plot points corresponding to each R-R space of a record).
CHU de Saint Etienne
Saint-Etienne, France
change form baseline high frequency index (HFnu) of variability RR short-term heart rate (HRV) in the frequency domain, from the parent and the child at 1 hour
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
Evaluation of the NIPE index of comfort and discomfort (Mdoloris Medical Systems ®) for the newborn
NIPΣ (neonatal index of parasympathetic activity) : evaluate the comfort of the newborn during the skin-to-skin session. NIPΣ is physiologically above 60%. The threshold of discomfort in the newborn would correspond to a value \<60.
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
Evaluation of the ANI index of comfort and discomfort (Mdoloris Medical Systems ®) for the parent.
ANI (analgesia nociception index) : evaluate an index of continuous analgesia during the skin-to-skin session. ANI is physiologically above 60%. The threshold of discomfort in the newborn would correspond to a value \<60.
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
gestational age
Time frame: at the inclusion
Ptot (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
Ptot (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
VLF (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
VLF (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
LF (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
LF (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
HF (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
HF (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
ratio LF/HF (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
ratio LF/HF (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
SDNN (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
SDNN (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
SDANN (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
SDANN (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
pNN30 and pNN50 (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
pNN30 and pNN50 (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
RMSSD (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
RMSSD (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
SD1 and SD2 (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
SD1 and SD2 (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
Poincaré-plot index (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
Poincaré-plot index (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
fractal index (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
fractal index (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
entropy index (indices of variability of heart rate) for the parent
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
entropy index (indices of variability of heart rate) for the newborn
Measured during the ECG recording
Time frame: Minutes 0 (early skin to skin), 10, 20, 30, 40, 50 and 60.
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