oxytocin and Infant--Premature--Diseases

Premature infants and their parents experience significant stress related to separation and lifesaving procedures. While evidence suggests that skin-to-skin contact (SSC) is a stress-reducing intervention for both neonates and parents, the mechanisms that underlie its efficacy are not well understood.. Purpose of this systematic review is to summarize the current state of knowledge on changes in biomarkers (ie, oxytocin [OT], cortisol, hypoxanthine, xanthine, uric acid, and allantoin), associated with SSC in premature infants and parents, that may reflect physiologic responses to stress.. A comprehensive literature search was conducted from 1990 to 2020. Studies were selected using prespecified inclusion and exclusion criteria.. Of the 175 studies identified, only 19 are included in this review. Ten studies evaluated only infants, 2 evaluated only parents, and 7 evaluated for changes in biomarkers in both infants and parents. Cortisol was the most common biomarker evaluated. While changes in infants' cortisol levels were highly variable, in 55% of the parent studies, parent cortisol levels decreased following SSC. In both parents and infants, OT levels decreased following SSC. Only 1 study found that allantoin levels were significantly lower in infants who received SSC.. While evidence suggests the numerous benefits of SSC, additional research is needed to identify the optimal biomarker to determine the mechanisms that underlie these effects. The use of novel biomarkers (eg, gene expression changes microbiome) may provide new insights into the mechanisms that underlie the efficacy of SSC.Video Abstract available at:https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=48.

Topics: Allantoin; Biomarkers; Child; Humans; Hydrocortisone; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Kangaroo-Mother Care Method; Oxytocin; Parents

Preterm infants undergo early separation from parents and are exposed to frequent painful clinical procedures, with resultant short- and long-term effects on their neurodevelopment. We aimed to establish whether the mother's voice could provide an effective and safe analgesia for preterm infants and whether endogenous oxytocin (OXT) could be linked to pain modulation. Twenty preterm infants were exposed to three conditions-mother's live voice (speaking or singing) and standard care-in random order during a painful procedure. OXT levels (pg/mL) in saliva and plasma cortisol levels were quantified, and the Premature Infant Pain Profile (PIPP) was blindly coded by trained psychologists. During the mother's live voice, PIPP scores significantly decreased, with a concomitant increase in OXT levels over baseline. The effect on pain perception was marginally significant for singing. No effects on cortisol levels were found. The mother's live voice modulated preterm infants' pain indicators. Endogenous OXT released during vocal contact is a promising protective mechanism during early painful interventions in at-risk populations.

Topics: Adult; Body Weight; Female; Heart Rate; Humans; Infant; Infant Behavior; Infant, Premature; Infant, Premature, Diseases; Mothers; Oxytocin; Pain; Pain Management; Pain Measurement; Saliva; Voice

Topics: Dexamethasone; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Jaundice, Neonatal; Obstetric Labor, Premature; Oxytocin; Pregnancy; Respiratory Distress Syndrome, Newborn; Tocolytic Agents

Topics: Adult; Anesthesia, Obstetrical; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Jaundice, Neonatal; Male; Meperidine; Oxytocin; Pregnancy; Sex Factors

Jaundice appearing in the first 24 hours of life, usually called early jaundice, is regarded as pathologic. On the opposite, one of the defining criteria of physiologic jaundice is its' occurrence after the first day of postnatal life. Authors, starting from repeated clinical observations of early jaundice of unknown etiology in preterm newborns, bring about a retrospective study of 1,527 clinical records in order to identify the cases of early jaundice of unknown origin. After known early jaundice-producing causes were excluded, 11 "unknown origin" cases were left. On comparing them with 11 other cases of similar characteristics (gestational age, weight at birth, year and season) who had presented physiologic jaundice, it turned out that the evolution of jaundice was comparable in both groups, except for age of appearance. Early jaundice group bilirubinemia was X = 7.4 (SD +/- 1.59 mg./dl. at 14 (+/- 6.6) hours of age, and physiologic jaundice group bilirubinemia was X = 9.8 (SD +/- 2.25) mg./dl. at 53 (+/- 21.3) hours at age. Since according to selection criteria both groups were made up by healthy preterm newborns, without any perinatal pathology, a study of the drugs administered to the mothers within 24 hours prior to birth was performed: not any reason for early appearance of jaundice was found. Authors' hypothesis support that the chronological criteria used to define physiologic jaundice in full-term newborns cannot always be applied to preterm newborns.

Topics: Age Factors; Bilirubin; Birth Weight; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature, Diseases; Jaundice, Neonatal; Male; Meperidine; Oxytocin; Promethazine

Neonatal hyperbilirubinaemia is increasing in frequency. In view of conflicting evidence about the possible causes, retrospective analyses have been carried out among babies born during six months of 1974. Preliminary analysis confirmed the over-riding importance of preterm birth (before 37 weeks), but only one of 17 such cases could be attributed to ill-judged artificial induction of labor. For the main analysis, the incidence of eight possibly relevant antecedent factors was compared in 46 cases of hyperbilirubinaemia (unconjugated bilirubin more than 15 mg per 100 ml in term babies and more than 13 mg per 100 ml in some preterm babies) and in 92 controls matched for sex and gestational age. Induction of labour by "primary" oxytocin infusion and artificial rupture of the membranes was very significantly more common in the index cases (p less than 0-01), but there was no difference in the incidence of "secondary" oxytocin, used to accelerate spontaneous labour. Evidence of uterin unresponsiveness suggests that the natural onset of labour was being anticipated by at least some days in many of the index cases and this could prevent the natural "priming" of the fetal enzyme systems. An excess of epidural analgesia in the mothers of the index cases was probably due to its association with the need for pain relief during "primary" oxytocin infusions. The higher incidence of postnatal weight loss in the index cases presumably contributed to the hyperbilirubinaemia.

Topics: Anesthesia, Epidural; Bilirubin; Birth Weight; Breast Feeding; Contraceptives, Oral; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Jaundice, Neonatal; Labor, Induced; Meperidine; Oxytocin; Pregnancy; Pregnancy Trimester, Third; Retrospective Studies

Topics: Asphyxia Neonatorum; Birth Weight; Female; Humans; Hydrogen-Ion Concentration; Hyperbilirubinemia; Infant, Newborn; Infant, Premature, Diseases; Jaundice, Neonatal; Labor, Induced; Oxytocin; Pregnancy

Topics: Amniotic Fluid; Asphyxia; Cesarean Section; Delivery, Obstetric; Female; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Premature, Diseases; Labor, Induced; Methods; Obstetric Labor Complications; Obstetrical Forceps; Oxytocin; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy, Prolonged; Retrospective Studies; Time Factors; Vaginal Smears