Neurobehavioral signals in preterm infants in body weight check: a quasi-experimental study

Araújo, Bárbara Bertolossi Marta de; Soares, Juliana Mello Duarte; Rodrigues, Giullia Taldo; Souza, Mariana dos Santos; Brito, Flávia dos Santos Barbosa; Reis, Adriana Teixeira; Sá Neto, José Antônio de; Marta, Cristiano Bertolossi

doi:10.1590/0034-7167-2021-0584

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (Suppl 2) • 2022 • https://doi.org/10.1590/0034-7167-2021-0584 copy

Neurobehavioral signals in preterm infants in body weight check: a quasi-experimental study

Señales neuroconductuales en prematuros en la verificación del peso corporal: un estudio cuasiexperimental

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to describe and compare the frequency of neurobehavioral signs in preterm infants in traditional and humanized body weight check.

Methods:

a quantitative, quasi-experimental, cross-over study, carried out in a Neonatal Unit at a university hospital with a sample of 30 preterm newborns, randomly assigned and allocated in control group (traditional) and intervention group (humanized), with collection of general data, vital signs before and after procedures and footage.

Results:

there was a higher frequency of approach signs in humanized weight check compared to traditional check. Moreover, withdrawal signs were more frequent in traditional weight check compared to humanized check.

Conclusion:

in this regard, humanized body weight check provided greater benefits to preterm infants, making it necessary to foster discussions about humanization of care, so that this practice can be performed routinely in health units.

Descriptors:
Infant; Premature; Neurobehavioral Signs; Humanization of Assistance; Intensive Care; Neonatal; Body Weight

Characteristics	n	%
Reason for childbirth
Pre-eclampsia	11	36.7
Water break	4	13.3
Premature labor	3	10.0
Urinary tract infection	2	6.7
Risk pregnancy	2	6.7
Triplet pregnancy	2	6.7
Systemic lupus erythematous	2	6.7
Increased umbilical resistance	1	3.3
Cord prolapse	1	3.3
Oligohydramnios	1	3.3
Hyaline membrane disease	1	3.3
Sex
Female	15	50.0
Male	15	50.0
Type of childbirth
Vaginal	10	33.3
Caesarean section	20	66.7
Prematurity degree
Extreme premature	1	3.3
Very premature	10	33.3
Moderate to late	19	63.3
Birth weight
Normal weight	2	6.7
Low weight	18	60.0
Very low weight	7	23.3
Extremely low weight	3	10.0

Withdrawing	Body weight check technique
	Traditional		Humanized
	n	%	n	%
Autonomic	30
Tremulousness	18	60.0	2	6.7
Sudden movements	14	46.7	3	10.0
Scares	13	43.3	1	3.3
Change in skin color	12	40.0	0	-
Irregular breathing	6	20.0	0	-
Sneeze	0	-	2	6.7
Motor
Hyperextension of legs	30	100.0	21	70.0
Finger splays	26	86.7	5	16.7
Facial grimacing	18	60.0	8	26.7
Hyperextension of trunk	13	43.3	0	-
Greeting	8	26.7	0	-
Tongue extension	3	10.0	2	6.7
Behavioral and attention and interaction states
Apathetic stare	30	100.0	30	100.0
Irritability	13	43.3	1	3.3
Whimpering	9	30.0	4	13.3
Strained fussing or crying	9	30.0	1	3.3
Inconsolability	6	20.0	0	-
Discharge smiling	6	20.0	0	-
Silent cry	5	16.7	1	3.3
Glassy-eyed	4	13.3	3	10.0
Gaze aversion	2	6.7	0	-
Staring	1	3.3	0	-

Approach	Body weight check technique
	Traditional		Humanized
	n	%	n	%
Autonomic	30
Stable color	18	60.0	30	100.0
Regular breathing	6	20.0	13	43.3
Motor
Semiflexion or flexion of arms, legs, and trunks	14	46.7	19	63.3
Grip movement	14	46.7	7	23.3
Hand-to-face	10	33.3	10	33.3
Bulkhead search	8	26.7	8	26.7
Tucking	6	20.0	15	50.0
Foot clasping	6	20.0	8	26.7
Hand-to-mouth	6	20.0	5	16.7
Hand holding	6	20.0	3	10.0
Contacts of hands and feet with surfaces	5	16.7	7	23.3
Grasping	5	16.7	3	10.0
Relaxed face	4	13.3	21	70.0
Suck searching and sucking	3	10.0	1	3.3
Intertwined fingers	3	10.0	1	3.3
Fixed vision, hearing	1	3.3	13	43.3
Biting	1	3.3	5	16.7
Coordinated movements	0	-	18	60.0
Coordinated smooth movements	0	-	14	46.7
Suction search and effective suction	0	-	7	23.3
Behavioral and attention and interaction states
Calm down easily	3	10.0	11	36.7
Eyebrow elevation	2	6.7	5	16.7

	Body weight check type										p value
	Traditional					Humanized
	n	%	Median	Interquartile range		n	%	Median	Interquartile range
	n	%	Median	1^st quartile^ 1st quartile is equivalent to the 25th percentile (P25); 3rd quartile is equivalent to the 75th percentile (P75).	3^rd quartile^ 1st quartile is equivalent to the 25th percentile (P25); 3rd quartile is equivalent to the 75th percentile (P75).	n	%	Median	1^st quartile^ 1st quartile is equivalent to the 25th percentile (P25); 3rd quartile is equivalent to the 75th percentile (P75).	3^rd quartile^ 1st quartile is equivalent to the 25th percentile (P25); 3rd quartile is equivalent to the 75th percentile (P75).
Withdrawing
Autonomic	26	86.7	6.00	1.75	6.00	9	30.0	1.00	1.00	1.00	0.001
Motor	30	100.0	18.50	14.00	18.50	26	87.6	2.00	1.75	2.00	0.001
Attention and interaction state	18	60.0	4.50	1.75	4.50	6	20.0	1.00	1.00	1.00	0.001
Approach
Autonomic	19	63.3	1.00	1.00	1.00	30	100.0	1.00	1.00	1.00	0.002
Motor	27	90.0	4.00	3.00	4.00	29	96.7	7.00	3.00	7.00	0.022
Attention and interaction state	4	13.3	1.50	1.00	1.50	13	43.3	1.00	1.00	1.00	0.005

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[1] Corresponding author: Bárbara Bertolossi Marta de Araújo E-mail: betabertolossi@gmail.com