RETINOPATHY OF PREMATURITY SCREENING, STRESS-RELATED RESPONSES, THE ROLE OF NESTING

Aims/background-In a prospective study the degree of distress caused b y retinopathy of prematurity (ROP) screening in a cohort of preterm in fants was assessed and the modifying effects of nesting in reducing th eir discomfort was evaluated. Methods-38 preterm infants were included in the study. 19 infants were placed in a nest with boundaries (inter vention group) and 19 infants were placed on a cot blanket (control gr oup). Observations were made 2 minutes before, throughout, and 2 minut es after ROP examination. The factors observed were crying responses, neurobehavioural activity, and physiological changes (heart rate, oxyg en saturation). Recordings were made using a video camera for crying a nd neurobehavioural activity and an Oxypleth monitor for heart rate an d oxygen saturation. Results-During ROP screening, the total group of 38 infants (nested and nonnested combined) displayed increased neurobe havioural activity (p<0.01) and crying (p<0.01). The increased activit y and crying coincided with the invasive part of the procedure. The di stress caused by ROP screening was significantly less for the nested g roup compared with the non-nested group for both movement activity (p< 0.01) and crying (p<0.01). The physiological data, heart rate, and oxy gen saturation were not statistically significant. Conclusion-ROP scre ening is distressing for preterm infants, Nesting can significantly re duce this discomfort. The findings in this study are of value in desig ning more optimal ROP examination schedules for infants.