Infant neurobehavioral development.
The trend toward single-room neonatal intensive care units (NICUs) is increasing; however scientific evidence is, at this point, mostly anecdotal. This is a critical time to assess the impact of the single-room NICU on improving medical and neurobehavioral outcomes of the preterm infant. We have developed a theoretical model that may be useful in studying how the change from an open-bay NICU to a single-room NICU could affect infant medical and neurobehavioral outcome. The model identifies mediating factors that are likely to accompany the change to a single-room NICU. These mediating factors include family centered care, developmental care, parenting and family factors, staff behavior and attitudes, and medical practices. Medical outcomes that plan to be measured are sepsis, length of stay, gestational age at discharge, weight gain, illness severity, gestational age at enteral feeding, and necrotizing enterocolitis (NEC). Neurobehavioral outcomes include the NICU Network Neurobehavioral Scale (NNNS) scores, sleep state organization and sleep physiology, infant mother feeding interaction scores, and pain scores. Preliminary findings on the sample of 150 patients in the open-bay NICU showed a "baseline" of effects of family centered care, developmental care, parent satisfaction, maternal depression, and parenting stress on the neurobehavioral outcomes of the newborn. The single-room NICU has the potential to improve the neurobehavioral status of the infant at discharge. Neurobehavioral assessment can assist with early detection and therefore preventative intervention to maximize developmental outcome. We also present an epigenetic model of the potential effects of maternal care on improving infant neurobehavioral status.
Brown Center for Study of Children at Risk, Providence, RI 02905, USA. Blester@wihri.org
Barry M
BM
Lester
Robin J
RJ
Miller
Katheleen
K
Hawes
Amy
A
Salisbury
Rosemarie
R
Bigsby
Mary C
MC
Sullivan
James F
JF
Padbury
D001291:Attitude of Health Personnel; D002657:Child Development; D019052:Depression, Postpartum; D005190:Family; D005260:Female; D005865:Gestational Age; D006801:Humans; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000523:psychology*; D007363:Intensive Care Units, Neonatal / Q000639:trends; D007902:Length of Stay; D009420:Nervous System / Q000254:growth & development*; D010351:Patient Discharge; D010362:Patients' Rooms; D015430:Weight Gain
Pediatrics. 2009 Oct;124(4):1009-20
19786440
Pediatrics. 2010 Sep;126(3):443-56
20732945
Arch Dis Child. 1991 Feb;66(2):204-11
1825773
J Perinat Neonatal Nurs. 2006 Jan-Mar;20(1):98-102
16508475
Am J Health Syst Pharm. 1999 Jul 1;56(13):1319-25
10683129
J Hum Lact. 2006 Aug;22(3):305-14
16885490
J Pediatr Psychol. 2005 Apr-May;30(3):247-55
15784921
Clin Perinatol. 2004 Jun;31(2):331-52, viii
15289037
Pediatrics. 2005 Feb;115(2):396-405
15689337
Neonatal Netw. 2010 Mar-Apr 1;29(2):87-95
20211830
Semin Perinatol. 1979 Jan;3(1):61-72
384533
J Hosp Infect. 1998 Jul;39(3):213-9
9699141
J Perinatol. 1999 Jan;19(1):48-52
10685202
J Perinat Neonatal Nurs. 1991 Mar;4(4):47-54
1993985
Annu Rev Nurs Res. 1983;1:133-53
6365122
J Obstet Gynecol Neonatal Nurs. 2003 Jul-Aug;32(4):447-54
12903694
Nurs Res. 1988 Jul-Aug;37(4):213-6
3393427
Semin Fetal Neonatal Med. 2006 Oct;11(5):369-77
16690363
Pediatrics. 2009 Oct;124(4):e793-802
19752082
J Clin Ethics. 2001 Fall;12(3):239-50
11789067
Infant Behav Dev. 2010 Apr;33(2):115-24
20137814
J Perinat Neonatal Nurs. 2002 Jun;16(1):71-82
12083296
J Crit Care. 2002 Sep;17(3):176-80
12297993
JAMA. 1994 Sep 21;272(11):853-8
8078162
Neonatal Netw. 2002 Nov-Dec;21(7):15-23
12514985
Neurotoxicol Teratol. 2007 May-Jun;29(3):331-40
17258430
Child Dev. 1984 Oct;55(5):1887-93
6510059
J Consult Clin Psychol. 1987 Dec;55(6):846-52
3693650
J Pediatr. 2002 May;140(5):561-4
12032522
J Perinat Neonatal Nurs. 2005 Jul-Sep;19(3):210-1
16106226
Pediatrics. 2006 Nov;118 Suppl 2:S87-94
17079628
Infect Control Hosp Epidemiol. 1997 Jul;18(7):499-503
9247833
Pediatrics. 1998 Feb;101(2):194-200
9445491
N Engl J Med. 1985 Aug 15;313(7):401-4
3839567
Pediatrics. 2005 Jun;115(6):1645-51
15930228
Natl Vital Stat Rep. 2006 Sep 29;55(1):1-101
17051727
J Perinat Neonatal Nurs. 2000 Dec;14(3):78-91
11930381
Pediatrics. 2006 Jul;118(1):e115-23
16818526
J Pediatr Nurs. 1998 Oct;13(5):279-89
9798363
Res Nurs Health. 1995 Oct;18(5):385-94
7676072
Adv Neonatal Care. 2006 Oct;6(5):261-70
17045946
Pediatrics. 2006 Dec;118(6):e1621-6
17074842
Pediatrics. 2001 Jan;107(1):14-22
11134428
J Perinat Neonatal Nurs. 2001 Dec;15(3):39-57
11785577
Clin Perinatol. 2004 Jun;31(2):313-22, vii-viii
15289035
Pediatrics. 1996 Jul;98(1):71-5
8668415
Dialogues Clin Neurosci. 2005;7(2):103-23
16262207
Clin Infect Dis. 2000 Sep;31(3):717-22
11017821
J Perinatol. 2010 May;30(5):343-51
20072132
Neonatal Netw. 2000 Jun;19(4):23-9
11949099
J Hosp Infect. 2007 Apr;65(4):292-306
17350726
J Perinatol. 1998 Nov-Dec;18(6 Pt 2 Su):S13-7
10023374
J Perinat Neonatal Nurs. 2006 Jan-Mar;20(1):51-5
16508463
J Dev Behav Pediatr. 1986 Aug;7(4):217-23
3745447
Neonatal Netw. 2005 Nov-Dec;24(6):25-32
16383182
Child Dev. 1983 Oct;54(5):1199-210
6354627
Pediatrics. 1992 Jun;89(6 Pt 2):1267
1594388
Clin Perinatol. 1998 Sep;25(3):613-26, ix
9779337
Pediatrics. 1997 Oct;100(4):724-7
9836852
J Perinat Neonatal Nurs. 2001 Sep;15(2):49-64
12095028
J Perinat Neonatal Nurs. 2006 Jan-Mar;20(1):46-50
16508462
J Obstet Gynecol Neonatal Nurs. 2006 Jan-Feb;35(1):105-15
16466358
AACN Clin Issues Crit Care Nurs. 1991 May;2(2):346-54
2021521
Ment Retard Dev Disabil Res Rev. 2005;11(1):14-20
15856444
Dev Med Child Neurol. 1979 Jun;21(3):344-52
467817
Heart Lung. 2001 Jan-Feb;30(1):74-84
11174370
JAMA. 1999 Mar 3;281(9):799-805
10071000
Pediatrics. 2006 Aug;118(2):e449-59
16882786
MCN Am J Matern Child Nurs. 2005 Nov-Dec;30(6):397-403; quiz 404-5
16260945
J Pediatr Nurs. 1997 Aug;12(4):214-22
9271882
Pediatrics. 2004 Apr;113(4):833-9
15060235
J Infect Dis. 1981 Nov;144(5):449-59
7310176
Drug Alcohol Depend. 2001 Jun 1;63(1):97-103
11297835
Pediatrics. 2003 Apr;111(4 Pt 2):e437-49
12671164
J Perinatol. 2007 Dec;27 Suppl 2:S32-7
18034178
Arch Surg. 1994 Dec;129(12):1306-9
7986161
Pediatrics. 2005 Apr;115(4):997-1003
15805376
Adv Neonatal Care. 2006 Oct;6(5):271-80
17045947
J Hosp Infect. 2007 Apr;65(4):314-8
17350722
Nat Neurosci. 2004 Aug;7(8):847-54
15220929
Pediatrics. 2006 Dec;118(6):2461-71
17142532
Clin Perinatol. 2004 Jun;31(2):353-82, ix
15289038
Pediatrics. 2009 Aug;124(2):717-28
19651588
Work. 2009;33(2):211-27
19713631
Pediatrics. 2009 Oct;124(4):1021-30
19786441
Diabetes. 2005 Jul;54(7):1899-906
15983188
J Pediatr. 2002 Feb;140(2):192-9
11865270
Pediatr Res. 2010 Mar;67(3):330-5
19952869
Neurotoxicol Teratol. 2005 Mar-Apr;27(2):213-20
15734272
NCHS Data Brief. 2010 May;(39):1-8
20604990
Pediatrics. 2003 Jun;111(6 Pt 1):1318-23
12777547
Neonatal Netw. 2000 Apr;19(3):13-21
11949060
J Neuroendocrinol. 2000 Jan;12(1):5-12
10692138
J Perinatol. 1998 Nov-Dec;18(6 Pt 2 Su):S38-44
10023378
Pediatrics. 2006 Nov;118(5):e1414-27
17043133
J Perinatol. 2000 Dec;20(8 Pt 2):S88-93
11190706
Appl Nurs Res. 2006 Aug;19(3):118-25
16877190
Nurs Res. 1993 Jan-Feb;42(1):36-41
8424066
Adv Neonatal Care. 2002 Aug;2(4):198-221
12881934
J Obstet Gynecol Neonatal Nurs. 2004 Jul-Aug;33(4):421-7
15346667
MCN Am J Matern Child Nurs. 2003 May-Jun;28(3):174-80; quiz 181-2
12771696
JAMA. 2005 Jul 20;294(3):318-25
16030276
Dev Psychopathol. 2003 Fall;15(4):1017-47
14984136
J Otolaryngol. 2002 Dec;31(6):355-60
12593547
Psychosomatics. 2006 May-Jun;47(3):206-12
16684937
Am J Perinatol. 1998 Aug;15(8):469-77
9788645
Pediatrics. 2006 May;117(5):e909-23
16651294
J Hosp Infect. 2002 Jan;50(1):18-24
11825047
J Dev Behav Pediatr. 1995 Dec;16(6):412-7
8746550
J Perinatol. 2002 Dec;22(8):641-5
12478446
Arch Dis Child Fetal Neonatal Ed. 2005 Jan;90(1):F73-4
15613582
Pediatrics. 1980 Jan;65(1):143-5
7355011
Arch Dis Child Fetal Neonatal Ed. 2004 Sep;89(5):F445-50
15321968
Neonatal Netw. 1998 Mar;17(2):33-8
9592498
Pediatrics. 2000 Jun;105(6):1216-26
10835060
NAACOGS Clin Issu Perinat Womens Health Nurs. 1992;3(1):34-44
1562445
Pediatrics. 1994 Feb;93(2):241-6
8121735