Measures of Stress Exposure for Hospitalized Preterm Infants.
Marliese Dion Nist, Tondi M Harrison, Rita H Pickler and 1 others
PMID 32604153WHAT IT FOUND
Stress exposure counts from the first two weeks of life did not predict neurobehavior at 35 weeks.
Simple counts of skin-breaking and invasive procedures were easier to extract from records than the Neonatal Injury Severity Score, which required interpretation of nursing notes.
Key findings
01No measure of stress exposure was significantly associated with neurobehavior scores when controlling for birth age, sex, and illness severity.
02Counts of skin-breaking and invasive procedures were objective and efficient to collect from electronic health records, requiring about 15 minutes per infant.
03The Neonatal Injury Severity Score required interpretation of nursing documentation, making data collection more tedious and less reliable.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study only measured stress exposure during the first 14 days of life, missing later stressors. Neurobehavior was assessed only at 35 weeks, so longer-term developmental effects were not captured. The sample was not diverse, with 77.9% of infants being White, limiting generalizability. The NAPI assessment has a ceiling effect and limited data on its predictive validity for long-term outcomes.
Declared interests
The study was supported by the National Institutes of Health. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that early stress exposure has no impact on development. This study found no association with neurobehavior at 35 weeks using specific measures, but it did not test physiologic stress responses or later developmental outcomes.