Assessment and Correction of Stress in Preterm Infants and Their Mothers

Objective: To investigate how skin-to-skin contact influences the stress levels in preterm infants in the neonatal intensive care unit and their mothers. Materials and Methods: The study included 60 preterm infants with gestational age less than 32 weeks, who were treated in the neonatal intensive care unit, and their mothers. The overall design was a baseline-response design. Saliva was collected before (baseline) and after skin-to-skin contact to measure free cortisol by enzyme immunoassay method. Results: Infant baseline salivary cortisol level was 0.587 [0.239; 1.714] μg/dL. It was significantly higher in neonates who had invasive ventilation (1.00 [0.38; 2.44]) μg/dL compared to non-ventilated infants (0.335 [0.156; 1.236]) μg/dL, P = .022 and was positively correlated with the duration of ventilation (r = 0.70; P = .0000). Maternal baseline salivary cortisol level was 0.212 [0.123; 0.378] μg/dL. There was significant decreasing of salivary cortisol after Kangaroo mother care with skin-to-skin contact in infants (0.162 [0.111; 0.231]) μg/dL, P < .001 and mothers (0.096 [0.077; 0.156]) μg/dL, P < .001. Conclusion: Preterm infants in the neonatal intensive care unit and their mothers experience stress which can be confirmed by the increased baseline cortisol levels. Kangaroo mother care with skin-to-skin contact reduces the stress and normalizes salivary cortisol levels in both the infant in the neonatal intensive care unit and the mother.