Co-bedding between preterm twins attenuates stress response after heel lance: results of a randomized trial.

TitleCo-bedding between preterm twins attenuates stress response after heel lance: results of a randomized trial.
Publication TypeJournal Article
Year of Publication2014
AuthorsCampbell-Yeo ML, C Johnston C, Joseph KS, Feeley N, Chambers CT, Barrington KJ, C-D Walker
JournalClin J Pain
Volume30
Issue7
Pagination598-604
Date Published2014 Jul
ISSN1536-5409
KeywordsBlood Specimen Collection, Female, Gestational Age, Heel, Humans, Hydrocortisone, Infant, Infant Care, Male, Premature Birth, Retrospective Studies, Saliva, Statistics, Nonparametric, Stress, Psychological
Abstract

OBJECTIVE: To examine the effect of co-bedding between preterm twins on stress response after heel lance.METHODS: Using a multisite randomized controlled trial design, stable preterm twins (67 sets, N=134 infants) between 28 and 36 completed weeks' gestational age, stratified by gestational age (≤ and >32 weeks) and site, were randomly assigned to a co-bedding group, cared for continuously in the same incubator or crib or a standard care group, cared for in a separate incubator or crib, and underwent a medically indicated heel lance after at least 24 hours and no greater than 10 days of group allocation. The reported outcome was cortisol from saliva samples from 89 twins (n=49 co-bedding, n=40 standard care) collected immediately before the heel lance (baseline levels) and 113 twins (n=58 co-bedding, n=55 standard care) collected 20 minutes after heel lance (stress levels) as an index of stress response.RESULTS: No group differences were noted in baseline salivary cortisol levels: 0.36 μg/dL (SD 0.25) in the co-bedding group and 0.43 μg/dL (SD 0.50) in the standard care group. Twenty minutes after lance, levels were significantly lower in the co-bedding group, 0.28 μg/dL (SD 0.25) versus 0.50 μg/dL (SD 0.73) in the standard group (P=0.04). Similarly, the mean of paired changes in salivary cortisol from baseline was lower in the co-bedding group (-0.06 μg/dL) compared with the standard care group (0.14 μg/dL, P<0.05).DISCUSSION: Co-bedding attenuates the stress response of preterm twins undergoing heel lance.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT009176.

DOI10.1097/AJP.0000000000000015
Alternate JournalClin J Pain
PubMed ID24300226
Grant List / / Canadian Institutes of Health Research / Canada

  • Douglas Hospital
  • Dobell Pavillion
  • Brain imaging centre