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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02473055
Other study ID # KangarooCareEEG
Secondary ID
Status Completed
Phase N/A
First received June 10, 2015
Last updated June 16, 2015
Start date January 2003
Est. completion date May 2015

Study information

Verified date June 2015
Source Case Western Reserve University
Contact n/a
Is FDA regulated No
Health authority United States: Institutional Review Board
Study type Interventional

Clinical Trial Summary

90 preterm infants were randomly assigned to kangaroo care (skin-to-=skin, chest-to-chest) group (n=50) or control (remained in incubator, prone (n=40) for a pretest period of 2- 3 hours, then fed, then KC group was placed in KC and control group remained in incubator for a 2-3 hr test period. EEG measures of sleep, HR, and RR were taken. .


Description:

The neonatal intensive care unit (NICU) environment is not conducive to sleep, and infant sleep in incubators is fragmented. Sleep contributes to brain maturation so interventions to foster sleep are needed. During Kangaroo Care (KC) behavioral indicators of Quiet Sleep have been observed but, not confirmed by objective electroencephalographic (EEG) analysis.The purpose was to determine the effects of Kangaroo Care (KC) on EEG-based sleep using Nihon Koden polysomnography and cardiorespiratory patterns by comparing KC sleep to incubator sleep.. A randomized controlled study with 90 preterms (KC = 50; control = 40) in which KC infants received 2-3 hours of KC between feeds after a comparable pretest period in an incubator and control infants remained in an incubator during the 2-3 hour pretest and test periods. In the incubator infants were inclined, prone, and nested; in KC infants were inclined, prone, and chest-to-chest underneath a blanket. The medically stable preterm infants were a mean 32 weeks postmenstrual age.


Recruitment information / eligibility

Status Completed
Enrollment 90
Est. completion date May 2015
Est. primary completion date June 2008
Accepts healthy volunteers No
Gender Both
Age group N/A to 37 Weeks
Eligibility Inclusion Criteria:

- Subjects whose five-minute APGARS were greater than 6, gestational age was 28 or more weeks at birth, and whose testing weight was greater than 1000 grams were included.

Exclusion Criteria:

- Infants with encephalopathy, intraventricular hemorrhage greater than grade II, white matter lucencies on cranial ultrasound, seizures, meningitis, or congenital brain malformations were excluded

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Other:
Kangaroo Care
skin-to-skin, chest-to-chest placement of diaper clad preterm infant up against his mother's chest and covered by a receiving blanket folded into fourths for 2-3 hours from one feeding to the next.

Locations

Country Name City State
United States UH hospitals Cleveland Ohio

Sponsors (1)

Lead Sponsor Collaborator
Case Western Reserve University

Country where clinical trial is conducted

United States, 

References & Publications (31)

Als H, Duffy FH, McAnulty GB, Rivkin MJ, Vajapeyam S, Mulkern RV, Warfield SK, Huppi PS, Butler SC, Conneman N, Fischer C, Eichenwald EC. Early experience alters brain function and structure. Pediatrics. 2004 Apr;113(4):846-57. — View Citation

Brazy JE, Goldstein RF, Oehler JM, Gustafson KE, Thompson RJ Jr. Nursery neurobiologic risk score: levels of risk and relationships with nonmedical factors. J Dev Behav Pediatr. 1993 Dec;14(6):375-80. — View Citation

Feldman R, Eidelman AI. Skin-to-skin contact (Kangaroo Care) accelerates autonomic and neurobehavioural maturation in preterm infants. Dev Med Child Neurol. 2003 Apr;45(4):274-81. — View Citation

Franco P, Scaillet S, Valente F, Chabanski S, Groswasser J, Kahn A. Ambient temperature is associated with changes in infants' arousability from sleep. Sleep. 2001 May 1;24(3):325-9. — View Citation

Franco P, Seret N, Van Hees JN, Lanquart JP Jr, Groswasser J, Kahn A. Cardiac changes during sleep in sleep-deprived infants. Sleep. 2003 Nov 1;26(7):845-8. — View Citation

Fransson AL, Karlsson H, Nilsson K. Temperature variation in newborn babies: importance of physical contact with the mother. Arch Dis Child Fetal Neonatal Ed. 2005 Nov;90(6):F500-4. — View Citation

Gerard CM, Harris KA, Thach BT. Spontaneous arousals in supine infants while swaddled and unswaddled during rapid eye movement and quiet sleep. Pediatrics. 2002 Dec;110(6):e70. — View Citation

Holditch-Davis D, Scher M, Schwartz T, Hudson-Barr D. Sleeping and waking state development in preterm infants. Early Hum Dev. 2004 Oct;80(1):43-64. — View Citation

Horne RS, Bandopadhayay P, Vitkovic J, Cranage SM, Adamson TM. Effects of age and sleeping position on arousal from sleep in preterm infants. Sleep. 2002 Nov 1;25(7):746-50. — View Citation

Lacy JB, Ohlsson A. Behavioral outcomes of environmental or care-giving hospital-based interventions for preterm infants: a critical overview. Acta Paediatr. 1993 Apr;82(4):408-15. Review. — View Citation

Lehtonen L, Martin RJ. Ontogeny of sleep and awake states in relation to breathing in preterm infants. Semin Neonatol. 2004 Jun;9(3):229-38. Review. — View Citation

Ludington-Hoe SM, Anderson GC, Swinth JY, Thompson C, Hadeed AJ. Randomized controlled trial of kangaroo care: cardiorespiratory and thermal effects on healthy preterm infants. Neonatal Netw. 2004 May-Jun;23(3):39-48. — View Citation

Ludington-Hoe SM, Johnson MW, Morgan K, Lewis T, Gutman J, Wilson PD, Scher MS. Neurophysiologic assessment of neonatal sleep organization: preliminary results of a randomized, controlled trial of skin contact with preterm infants. Pediatrics. 2006 May;117(5):e909-23. — View Citation

Mazurier E, Picaud JC. [Kangaroo mother care vs nidcap: a problem of semantics]. Arch Pediatr. 2005 Apr;12(4):471-2; author reply 473. French. — View Citation

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Mirmiran M, Maas YG, Ariagno RL. Development of fetal and neonatal sleep and circadian rhythms. Sleep Med Rev. 2003 Aug;7(4):321-34. Review. — View Citation

Ohgi S, Arisawa K, Takahashi T, Kusumoto T, Goto Y, Akiyama T, Saito H. Neonatal behavioral assessment scale as a predictor of later developmental disabilities of low birth-weight and/or premature infants. Brain Dev. 2003 Aug;25(5):313-21. — View Citation

OURTH L, BROWN KB. Inadequate mothering and disturbance in the neonatal period. Child Dev. 1961 Jun;32:287-95. — View Citation

Peirano P, Algarín C, Uauy R. Sleep-wake states and their regulatory mechanisms throughout early human development. J Pediatr. 2003 Oct;143(4 Suppl):S70-9. Review. — View Citation

Perlman JM. The genesis of cognitive and behavioral deficits in premature graduates of intensive care. Minerva Pediatr. 2003 Apr;55(2):89-101. Review. — View Citation

Pillai M, James D. Behavioural states in normal mature human fetuses. Arch Dis Child. 1990 Jan;65(1 Spec No):39-43. — View Citation

Scher MS, Jones BL, Steppe DA, Cork DL, Seltman HJ, Banks DL. Functional brain maturation in neonates as measured by EEG-sleep analyses. Clin Neurophysiol. 2003 May;114(5):875-82. — View Citation

Scher MS, Sun M, Steppe DA, Banks DL, Guthrie RD, Sclabassi RJ. Comparisons of EEG sleep state-specific spectral values between healthy full-term and preterm infants at comparable postconceptional ages. Sleep. 1994 Feb;17(1):47-51. — View Citation

Schrod L, Walter J. Effect of head-up body tilt position on autonomic function and cerebral oxygenation in preterm infants. Biol Neonate. 2002;81(4):255-9. — View Citation

Sesma HW, Georgieff MK. The effect of adverse intrauterine and newborn environments on cognitive development: the experiences of premature delivery and diabetes during pregnancy. Dev Psychopathol. 2003 Fall;15(4):991-1015. — View Citation

Spangler G, Scheubeck R. Behavioral organization in newborns and its relation to adrenocortical and cardiac activity. Child Dev. 1993 Apr;64(2):622-33. — View Citation

Törnhage CJ, Stuge E, Lindberg T, Serenius F. First week kangaroo care in sick very preterm infants. Acta Paediatr. 1999 Dec;88(12):1402-4. — View Citation

Tuladhar R, Harding R, Michael Adamson T, Horne RS. Comparison of postnatal development of heart rate responses to trigeminal stimulation in sleeping preterm and term infants. J Sleep Res. 2005 Mar;14(1):29-36. — View Citation

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White-Traut RC, Pate CM. Modulating infant state in premature infants. J Pediatr Nurs. 1987 Apr;2(2):96-101. — View Citation

Whitney MP, Thoman EB. Early sleep patterns of premature infants are differentially related to later developmental disabilities. J Dev Behav Pediatr. 1993 Apr;14(2):71-80. — View Citation

* Note: There are 31 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary EEG-based sleep Infants attached to EEG machine and Respiratory impedance plethysmography bands prior to beginning of pretest period and remainded on EEG until end of study 2-3 hours No
Secondary Heart rates during pretest Heart Rate was detected by Nihon Koden polysomnograph 2-3 hours of pretest No
Secondary Respiratory rate during pretest Impedance plethysmography belts attached to Nihon Koden polysomnograph machine 2-3 hours pretest No
Secondary Heart rates during test Heart rate was detected by Nihon Koden polysomnograph 2-3 hours of test No
Secondary Respiratory rate during test period Impedance plethysmography belts attached to Nihon Koden polysomnograph machine 2-3 hours test period No
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