Preterm infants' behaviors and skin conductance responses to nurse handling in the NICU

Stress response patterns are indicative of the neonate's unique ability to cope with environmental demands and can be evaluated through autonomic and behavioral response parameters.Objective: To characterize stress responses during tactile stimulation to standard nurse handling in the NICU, and their association with severity of illness in preterm infants.Methods: Thirty preterm neonates were studied at postnatal day 4-5 during standard nurse caregiving. Heart rate (HR), respiratory rate (RR), skin conductance responses per second (SCR/s), and NIDCAP (R) stress behaviors were recorded before and during care. Non-parametric tests were used to assess differences from before to during care. Pearson's correlations were used to determine the association of biological and behavioral variables to the score for neonatal acute physiology (SNAP), a severity of illness index.Results: HR, RR, SCR/s and NIDCAP (R) behaviors (motor and attentional cues, and ability to self-console) increased from before to during the care (p<0.01). NIDCAP (R) behaviors showed a significant negative association to the SNAP score (R =-0.45, p<0.05).Conclusions: HR, RR, SCR/s and NIDCAP (R) behaviors significantly increased during care. NIDCAP (R) stress behaviors were influenced by the severity of illness of the infant, while SCR/s was not influenced by severity of illness.