title: No indications of increased quiet sleep in infants receiving care based on the newborn individualized developmental care and assessment program (NIDCAP).
abstract: It has been proposed that the developmentally supportive care of very-low-birthweight (VLBW) infants provided by the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) can improve the infants' opportunities for rest and sleep. The aim of the present study was to determine whether quiet sleep (QS) in VLBW infants is affected by NIDCAP care. Twenty-two infants with a gestational age of <32 wk at birth randomly received either NIDCAP (n = 11) or conventional care (n = 11). These two groups were comparable (mean (SD)) with respect to birthweight (1021 (240) vs 913 (362)g, respectively) and gestational age (27.1 (1.7) vs 26.4 (1.8) wk). The infants in the NIDCAP group were cared for in a separate room by a group of specially trained nurses and subjected to weekly NIDCAP observations until they reached a postconceptional age (PCA) of 36 wk. Quiet sleep (QS) was assessed from 24-h amplitude-integrated EEGs recorded at 32 and 36 wk of PCA. The percentage of time [mean (SD)] spent in QS at 32 wk of PCA was 33.5 (2.6) % for the NIDCAP group and 33.3 (6.9) % for the control infants (ns). At 36 wk, the corresponding values were 24.5 (3.2) % and 25.7 (4.7) %, respectively (ns). The number of QS periods/24 h decreased equally in both groups in association with maturation: from 24.6 (3.3) to 16.8 (1.8) and from 25.0 (5.8) to 17.5 (3.3), at 32 wk, and 36 wk of PCA, respectively (NS).
  
  
  CONCLUSIONS
  There were no indications of increased QS at 32 or 36 wk of postconceptional age among VLBW infants who received care based on NIDCAP.
authors.affiliation: Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden. biorn.westrup@telia.com
authors.forename: B
authors.initials: B
authors.lastname: Westrup
authors.forename: L
authors.initials: L
authors.lastname: Hellström-Westas
authors.forename: K
authors.initials: K
authors.lastname: Stjernqvist
authors.forename: H
authors.initials: H
authors.lastname: Lagercrantz
mesh_terms: D002657:Child Development / Q000502:physiology; D003422:Critical Care / Q000379:methods; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007224:Infant Care / Q000379:methods / Q000458:organization & administration*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D017283:Neonatal Nursing / Q000379:methods*; D011336:Probability; D015397:Program Evaluation; D012016:Reference Values; D012680:Sensitivity and Specificity; D012890:Sleep / Q000502:physiology*; D018709:Statistics, Nonparametric; D013548:Sweden