title: Coregulation in salivary cortisol during maternal holding of premature infants.
abstract: OBJECTIVE
  The purpose of this study was to examine coregulation between mothers and preterm infants in hypothalamic-pituitary-adrenocortical (HPA) system activity, as indicated by salivary cortisol levels, while mothers held their infants. The research questions were (a) does mother-infant coregulation in HPA activity occur during holding? and (b) if mother- infant coregulation in HPA activity exists during holding, do type of holding, antenatal steroids, sound level, and maternal touch influence this coregulation?
  
  
  METHODS
  The sample consisted of 20 mother- infant dyads with infants at a mean postconceptional age of 34.7 weeks (+0.7) and average postnatal age of 15 days (+9) at the time of cortisol sampling.
  
  
  METHODS
  The design was exploratory using convenience sampling. Maternal and infant cortisol levels were obtained at Time 1 (baseline) and Time 2 (end of holding); at each time, the absolute differences in levels between mother and infant were determined. Coregulation was operationalized as less difference between maternal-infant cortisol levels immediately after holding (Time 2) as compared to before holding (Time 1).
  
  
  RESULTS
  The two variables with the highest correlation with the Time 1/Time 2 difference score included antenatal steroids and ambient sound level, which were entered into a linear regression equation as predictor variables. A coregulatory relationship in cortisol levels existed between mothers and infants during holding, which was moderated by sound levels. Nurses in the neonatal intensive care unit (NICU) can facilitate the mother-infant relationship, as reflected in coregulatory measures, by promoting a quiet environment, particularly around mothers who are holding their infants.
authors.affiliation: School of Nursing, University of Colorado at Denver, Denver, Colorado, USA. Madalynn.neu@ucdenver.edu
authors.forename: Madalynn
authors.initials: M
authors.lastname: Neu
authors.forename: Mark L
authors.initials: ML
authors.lastname: Laudenslager
authors.forename: JoAnn
authors.initials: J
authors.lastname: Robinson
mesh_terms: D000311:Adrenal Glands / Q000502:physiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System; D007231:Infant, Newborn; D007234:Infant, Premature; D009034:Mother-Child Relations; D012463:Saliva / Q000737:chemistry*
chemical_list: D006854:Hydrocortisone