Search

Background & Aim: Mothers with premature babies are more likely to experience anxiety than mothers with full-term babies. The separation of the mother from the baby disrupts physical contact with the baby, which is the most important component affecting attachment. The aim of this study was to determine the effect of a group positive thinking program on anxiety and attachment in mothers with premature infants admitted to the neonatal intensive care unit. Methods & Materials: This study is a randomized clinical trial conducted in Kermanshah in 2020. A total of 72 mothers with premature infants admitted to the neonatal intensive care unit of Imam Reza and Mohammad Kermanshahi hospitals were randomly assigned into two groups of control and intervention. The Spielberger State Trait Anxiety Inventory and Postpartum Attachment Scale were used to collect the data. The collected data were analyzed using the SPSS software version 16 using statistical tests (ANOVA and Chi-Square). Results: There was no significant difference in the state anxiety levels before (p =0.791) and after the intervention (p =0.373) between the control and intervention groups. Likewise, no statistically significant difference was observed in the latent anxiety levels before (p =0.831) and after the intervention (p =0.093) between the two groups but comparing the amount of changes showed a significant difference (p =0.025). Regarding attachment, none of the attachment subscales had a statistically significant difference between the two groups before the intervention (p>0.05). After the intervention, a significant difference was observed in the scores of the subscales “lack of hostility" and "satisfaction with the interaction" (p

Background and Objectives: Hypocalcemia is one of the most common neonatal disorders that has a good prognosis if treated promptly and diagnosed correctly. This study aimed to determine the prevalence of hypocalcemia and associated factors in premature infants in Jiroft, southeastern Iran. Materials and Methods: In this cross-sectional study, the cases of infants born in the spring and summer of 2019 in Imam Khomeini Hospital in Jiroft, southeastern Iran, were examined by the census method. The required information was extracted from the infants' files and entered into SPSS24 software for analysis. Results: Based on the results of the study, out of 78 hypocalcemic premature neonates admitted to Imam Khomeini Hospital, 42 (53.8%) were boys and 36 (46.2%) were girls. Thirty-six (46.2%) infants had a birth weight of between 1,500 and 2,000 g, and 42 (35.8%) infants were born between 35 and 37 weeks of age. Most preterm infants (60.3%) had a diabetic mother. Moreover, the number of female preterm hypocalcemic infants with a weight of 2,000 to 2,500 g was higher than their male counterparts. Conclusion: The results of this study indicated that prematurity, weight less than 2,000 g, and maternal diabetes were the factors affecting hypocalcemia in preterm infants that should be considered in public health programs. [ABSTRACT FROM AUTHOR]

Background and Objectives: Hypocalcemia is one of the most common neonatal disorders that has a good prognosis if treated promptly and diagnosed correctly. This study aimed to determine the prevalence of hypocalcemia and associated factors in premature infants in Jiroft, southeastern Iran. Materials and Methods: In this cross-sectional study, the cases of infants born in the spring and summer of 2019 in Imam Khomeini Hospital in Jiroft, southeastern Iran, were examined by the census method. The required information was extracted from the infants' files and entered into SPSS24 software for analysis. Results: Based on the results of the study, out of 78 hypocalcemic premature neonates admitted to Imam Khomeini Hospital, 42 (53.8%) were boys and 36 (46.2%) were girls. Thirty-six (46.2%) infants had a birth weight of between 1,500 and 2,000 g, and 42 (35.8%) infants were born between 35 and 37 weeks of age. Most preterm infants (60.3%) had a diabetic mother. Moreover, the number of female preterm hypocalcemic infants with a weight of 2,000 to 2,500 g was higher than their male counterparts. Conclusion: The results of this study indicated that prematurity, weight less than 2,000 g, and maternal diabetes were the factors affecting hypocalcemia in preterm infants that should be considered in public health programs.

Background & Aim: Mothers with premature babies are more likely to experience anxiety than mothers with full-term babies. The separation of the mother from the baby disrupts physical contact with the baby, which is the most important component affecting attachment. The aim of this study was to determine the effect of a group positive thinking program on anxiety and attachment in mothers with premature infants admitted to the neonatal intensive care unit. Methods & Materials: This study is a randomized clinical trial conducted in Kermanshah in 2020. A total of 72 mothers with premature infants admitted to the neonatal intensive care unit of Imam Reza and Mohammad Kermanshahi hospitals were randomly assigned into two groups of control and intervention. The Spielberger State Trait Anxiety Inventory and Postpartum Attachment Scale were used to collect the data. The collected data were analyzed using the SPSS software version 16 using statistical tests (ANOVA and Chi-Square). Results: There was no significant difference in the state anxiety levels before (p =0.791) and after the intervention (p =0.373) between the control and intervention groups. Likewise, no statistically significant difference was observed in the latent anxiety levels before (p =0.831) and after the intervention (p =0.093) between the two groups but comparing the amount of changes showed a significant difference (p =0.025). Regarding attachment, none of the attachment subscales had a statistically significant difference between the two groups before the intervention (p>0.05). After the intervention, a significant difference was observed in the scores of the subscales “lack of hostility" and "satisfaction with the interaction" (p<0.05). Conclusion: According to the findings of the study, the group positive thinking training is recommended to the nurses and managers of neonatal intensive care units as a complementary program, along with the routine care for mothers of premature infants. [ABSTRACT FROM AUTHOR]

Background and Objective: Premature birth is an unexpected event that causes a lot of stress for parents as they are not psychologically and emotionally prepared to face it. Therefore, this study aimed to determine the effect of multi-sensory stimulation of neonates by mothers on the stress level of mothers with premature neonates hospitalized in the Neonatal Intensive Care Unit (NICU). Materials and Methods: This quasi-experimental study was performed on 80 mothers (in experimental and control groups) who were selected using the census method in the NICU of Shahid Sadoughi Hospital, in Yazd, Iran. The infants in the experimental group were stimulated twice a day from the third to the sixth day. Data were collected using demographic characteristics form and Parental Stress Scale that were completed before and after the intervention. Data were analyzed in SPSS software (version 20) through statistical tests. Results: There was no significant difference between the mean stress levels in the two study groups before intervention; however, there were significant differences in intervention and control groups post-intervention in the mean±SD score of stress (P

Background & Aims: Infant hospitalization in the intensive care unit is a psychological crisis for the family that causes stress and disability for the family. In critical situations, the knowledge of the healthcare team is devoted to patient care, while it is necessary to emphasize the needs of the family. This study aims to determine the impact of family-centered empowerment model on quality of life of premature infants parents’ were admitted to the neonatal intensive care unit. Materials & Methods: This quasi-experimental controlled study was performed on 84 parents with preterm infants admitted to the intensive care unit. Samples were continuously targeted in both intervention and control groups. They received training sessions in four steps and 8 sessions. The ability of the subjects was also assessed by the competency questionnaire (including three dimensions; threat perception, self-efficacy and self-esteem). Demographic questionnaire, and WHOQOL-BREF quality of life questionnaire once at the beginning of the study and again one month after completion. Intervention sessions were completed and the data were analyzed using Chi-square, independent t-test, analysis of variance and Spearman and Shapiro-Wilk correlation coefficient using SPSS software. Results: There was no significant difference between the two groups in terms of demographic characteristics and baseline competency scores (self-efficacy, self-esteem, severity and sensitivity) and quality of life. Comparison of total quality of life score (P=0.041) in the intervention group was significantly higher than the control group. In-group comparison, empowerment scores [self-esteem, self-efficacy (P

Background: The Coronavirus Disease 2019 (COVID-19) pandemic and lockdown have had a profound impact on the emotions, anxiety, and mental health of communities and premature infants as one of the most vulnerable groups in society whose health depends on the health of the mother.Aim: This study aimed to determine the psychological impact of COVID-19 on mothers with premature infants admitted to the neonatal intensive care unit (NICU).Method: This cross-sectional study was conducted during the COVID-19 pandemic from December 2020 to March 2021 through convenience sampling on 190 mothers whose preterm infants were admitted to the NICUs of the selected hospitals in Isfahan, Iran. Corona Disease Anxiety Scale, a Multidimensional Scale of Perceived Social Support, and Maternal-Neonatal Demographic Characteristics were used for data collection. The obtained data were analyzed using t-test, ANOVA, Pearson correlation coefficient, and multiple regression.Results: The mean total score of COVID-19 anxiety (12.21±10.31) was reported at a mild level, and perceived social support (66.55±12.81) was at a high level. Based on the final results of the multiple regression model, COVID-19 anxiety, and the levels of mothers' income and education were significant predictors of perceived social support. No significant relationship was observed between COVID-19 anxiety and perceived social support.Implications for Practice: The results showed that the levels of psychological factors and their relationship with other factors can be varied in the COVID-19 pandemic condition. Therefore, a decrease or an increase in the perceived social support did not affect the level of COVID-19 anxiety in mothers with premature infants.

Introduction: Neonatal respiratory distress is a life-threatening lung disorder, so it is important to examine the effect of different intervention and care methods on respiratory distress in premature infants. The aim of this study was to determine the effect of foot reflex massage on the reduction of respiratory distress in premature infants in the intensive care unit. Methods: In this study, in 2018, 100 premature infants were randomly assigned to two intervention and control groups by clinical trial method. In the intervention group, reflexive foot massage was performed for three days and the control group received normal care. In both groups, a personal profile questionnaire and a respiratory distress index were completed before and after the intervention. Data analysis was performed using SPSS 16. Results: The results showed that in the intervention and control group, the difference between mean oxygen saturation (Spo2) and respiratory distress rate on the third day after the intervention was statistically significant and in infants who undergone interventional foot massage, the mean respiratory distress is lower than the control group and oxygen saturation is higher than the control group Conclusion: Reflective foot massage is effective on physiological responses and reducing respiratory distress in premature infants. It seems that this easy, cheap and efficient intervention program can be considered in the executive instructions of health care and nurses' intervention and its education to mothers can be included in the country's educational programs.

Background & Aims: The birth of a premature and sick infant leads to a severe psychological crisis for the parents. The birth of an infant is associated with numerous changes in the family function in terms of lifestyle, leisure, and relations of the family members. When an infant is born in need of medical care, these changes are intensified, and the family members experience increased mental pressure. Premature delivery and admission of the neonate adversely affects the emotional state of the mother, and one of the psychological reactions perceived by these mothers is the onset of depressive symptoms. Depressed mothers are faced with several challenges in the care of an inpatient infant, which are considered a risk factor for the deterioration of their mental health and dysfunction. Despite the advances in the quality care in neonatal intensive care units (NICUs) for infants, the psychological needs of their mothers have received less attention. The mothers of the premature infants admitted to NICUs experience various psychological issues (e.g., depression). These issues along with the physical complications of childbirth cause these women not to pay attention to their physical and mental health. Today, the identification and provision of early interventions to prevent and reduce these issues have become a priority of healthcare services in the world. The present study aimed to assess the effect of Fordyce happiness training on the depression of the mothers of the premature infants admitted to the NICUs of the medical centers in Zahedan, Iran. Materials & Methods: This quasi-experimental study was conducted in the spring and summer of 2019 on 80 mothers of the premature infants admitted to the NICUs of Zahedan. The subjects were selected via convenience sampling and divided into two groups of intervention (n=40) and control (n=40). For sampling, the researcher initially referred to the NICUs and identified the mothers of the admitted premature infants. After explaining the research objectives and obtaining written consent, the mothers who met the inclusion criteria were enrolled. The mothers of the control group were enrolled first, followed by the mothers of the intervention group in order to prevent the transfer of information in the groups. Prior to the study, the mothers were asked to complete the demographic information form and Beck depression inventory. The mothers of the intervention group received Fordyce happiness training in groups of 4-5 for six sessions every other day (45-60 minutes). Fordyce happiness training is a program designed to increase the happiness of community members, which consists of 14 cognitive and behavioral elements. In the present study, some of the components of Fordyce happiness training that were appropriate for the sample population were presented and discussed based on examples and experiences. One month after the intervention, the questionnaire was completed again. The control group received no other training than the routine educational program of the hospital, as well as the posttest simultaneous with the intervention group. Data analysis was performed in SPSS version 16 using statistical tests. Results: The minimum and maximum age of the mothers in the intervention and control groups was 15 and 31 years and 18 and 35 years, respectively. Most of the deliveries in the intervention group were natural (65%), and in the control group, the mode of delivery was equal in both groups (50%). No significant differences were observed in most of the variables between the groups, while the age of the mothers was significantly different between the groups. The analysis of covariance was used for the confounding effect of age, and the results of the analysis of covariance to adjust the effect of the pretest scores and age variable indicated a significant difference in the mean score of depression in the mothers of the preterm infants admitted to the NICU between the groups after Fordyce happiness training (P=0.0001). Therefore, the implementation of Fordyce happiness training in the intervention group could reduce the mean score of depression in the mothers. The mean score of maternal depression in the intervention group decreased from 23.72±5.81 before the intervention to 11.47±3.17 after the intervention. In the control group, the score increased from 21.82±10.58 before the intervention to 23.90±3.62 after the intervention. However, the results of independent t-test indicated that the mean score of maternal depression before intervention had no significant difference between the study groups (P=0.32), while it was considered significant after the happiness training in both the intervention and control groups (P=0.0001). Conclusion: According to the results, Fordyce happiness training could reduce depression in the mothers of the premature infants admitted to the NICU. Although the experience of childbirth is pleasant for the mother, giving birth to a premature infant and the admission of the infant could be an unpleasant experience, adversely affecting the emotional state and of the mother and giving rise to depressive symptoms. In order to maintain and promote the mental health of mothers, in addition to the care of the premature infant in medical centers, the health of the mother of the infant should also be considered. Fordyce happiness training could positively influence the reduction of depression in these mothers. Fordyce happiness training is a type of cognitive-behavioral intervention, which is used to reduce depression. This intervention enables the individual to find a more positive mindset in controlling distressing emotions and thoughts, which in turn enhances the cognition of patients by reducing depression. The reduction of depressive symptoms improves the performance of individuals in responsibilities and duties. The mothers who overcome their issues in this regard are able to participate in the care of the neonate during admission. Therefore, this training program could be implemented alongside family-oriented programs in medical centers, and it is essential to consider programs such as Fordyce happiness training to maintain and promote maternal mental health.

Background: Breastfeeding is a two-way interaction between mother and infant, the sustainability of which requires the presence of both parts given their complementary roles. Aim: The present study was conducted to investigate the effect of breast milk expression during kangaroo mother care (KMC) on milkvolume in mothers with premature neonates. Method: This quasi-experimental study was performed on 40 mothers with premature newborns admitted to a neonatal intensive care unit in a city in the west of Iran in 2019. The participants were randomly assigned into two groups of intervention and control. Breast milk in both groups was expressed 8 times a day from day 4 to day 6 after birth using a 20-cc syringe and recorded in a checklist. In the intervention group, two milking sessions were performed during the KMC. However, in the control group, milking was conducted according to the ward routine. Data were analyzed in SPSS software (version 23) using repeated-measures ANOVA. Results: The mean ages of the participants in the intervention and control groups were 29.05±4.09 and 27.85±3.58 years, respectively. There was a statistically significant difference between the milkvolume of the intervention and control groups on days 4 (P=0.04), 5 (P=0.02), and 6 (P=0.007) and between the total volume of milkduring the three days (P=0.01). Implications for Practice: Breast milk expression duringKMC could have a positive effect on increasing milkvolume. Therefore, can be recommended as an intervention to support mothers with insufficient milk.

Background: Premature infants undergo a lot of stressors during treatment procedures in the neonatal intensive care units which causes significant physiological changes in these neonates. Multi-sensory stimulation is a broad category of interventions designed to improve the evolutionary and physiological outcomes of premature infants hospitalized in the neonatal intensive care unit to minimize stress in this environment. So, the study aimed to evaluate the effect of multi-sensory stimulation on physiological parameters in preterm infants. Methods: This double-blind clinical trial conducted in the neonatal intensive care unit of Shahid Motahari Hospital in Jahrom from April to December 2016. In this study, 80 preterm infants with a gestational age of 34 to 36 weeks were selected by non-probability sampling method and were randomly divided into two groups of multi-sensory stimulation and control. Neonates in the intervention group received a multi-sensory stimulation program for 60 minute. The multi-sensory stimulation program was included a combination of auditory, tactile, motor and visual stimulation. The preterm infants in the control group received only usual care. The data collecting tool was a questionnaire and checklist for physiological parameters of preterm infants. Results: The results showed that the two groups were homogeneous in terms of fetal age, birth weight, the height of birth, first and fifth minute Apgar score of birth. The results showed that there was no significant difference between the mean of physiological indexes in the two groups before the intervention. Statistical tests showed that there was a decreasing trend in the average of all physiological indices during the intervention (first and second half during the intervention) (P

BACKGROUND AND OBJECTIVE: Despite the increased chance of premature survived infants, the morbidity of these infants is still significant. The number of NRBCs in the cord of these neonates may be effective in predicting the long-term complications of these neonates. The purpose of this study is to investigate the relationship between the number of nucleated red blood cells in the peripheral blood of preterm infants and the same prognosis about children at the age of two. METHODS: The present study is a cohort study, has been performed on 290 preterm infants younger than 32 weeks old admitted in neonatal ward of Ghaem hospital of Mashhad during years of 93 to 96 with available sampling. Cord blood samples were taken to determine NRBC/100WBC count. Data have been collected by a researcher-made checklist including neonatal, maternal, and laboratory characteristics. Infants' development up to two years of age has been studied. NRBC/100WBC numbers of infants were compared with normal prognosis (Denver 2 normal test) and abnormal prognosis (death or developmental delay). FINDINGS: Of 290 neonates, 160 of them (55.2%) had normal development, 61 cases (21%) died and 69 neonates (23.8%) had abnormal development. The mean number of mm2 /NRBC and NWBC/100WBC in neonates with abnormal prognosis were 4025.11±210.04 and 31.83±15.14 and in normal neonates were 367.47±76.91 and 5.5±5.29, respectively (p 300/mm2 suggests a poor prognosis at the age of two with a sensitivity of 75% and a specificity of 63%. CONCLUSION: According to these results the mean of NRBC2/mm2 and NRBC/100WBC can be helpful in determining neonatal prognosis at the age of two.

BACKGROUND AND OBJECTIVE: Transferring a premature infant from the hospital to home is a burden for the family. One of the most important goals of the health system is to facilitate the transition of the infant. The aim of this study was to investigate the effect of the presence of a support nurse on the safe transition of premature infants from the hospital to home. METHODS: This clinical trial was performed in the presence of 60 mothers of premature and very premature infants (26-35 weeks) discharged from the neonatal intensive care unit of a hospital in Isfahan (2018). Mothers were randomly assigned to control and intervention groups. Data collection was done through a questionnaire and a researcher-made checklist. The intervention included the presence of a support nurse from the time of discharge, who accompanied them along the way, and stayed at their home for 1 to 3 hours. The nurse supported the family by training and performing the required care. The effect of the nurse s presence on the variables of home environment, infant health status and safe transition conditions was evaluated and compared. FINDINGS: Based on the results of the study, the mean score of home environment (87.73±10.45) and the mean score of safe transition (83.79±17.90) in the control group were higher more than the intervention group (81.45±16.49 and 80.77±16.52, respectively). The mean score of infant health status was the same in the two groups. CONCLUSION: The results of the study showed that mothers were well empowered in intensive care units and discharge instructions have been able to provide safe transition for premature infants.

BACKGROUND AND OBJECTIVE: Mother - infant attachment is impaired with the hospitalization of the premature infant and separation from the family, which impairs the infant s development and the mother s ability to care for the infant. The aim of this study was to determine the effect of infant massage on attachment behaviors in mothers of premature infants. METHODS: This cluster randomized controlled trial was performed on 54 mothers and premature infants 34 to 36 weeks hospitalized in the intensive care unit of Shahid Sadoughi and Afshar hospitals in Yazd. First, the research was divided into control and experimental groups by random draw method and then the samples were selected by convenience sampling. In the experimental group, each mother massaged her infant once a day for 5 consecutive days. The control group received only the routine care. Maternal attachment was measured and compared using Avant s mother-infant attachment behavior questionnaire with a minimum score of zero and a maximum of 195 in both groups during breastfeeding and interaction with the infant, before the intervention, on the third day and fifth day after the intervention. FINDINGS: Mean score of mothers attachment behaviors in the experimental group on the third day (50.63±6.06) and the fifth day (66±9.96) showed a statistically significant difference with the control group on the third day (44.67±4.12) and the fifth day (49.70±4.75), respectively (p

Objective: Upon hospitalization of a premature infant immediately after giving birth, mothers would experience high levels of anxiety. One of the essential non-pharmacological interventions to control the anxiety is massage. The purpose of this study was to investigate the effect of massage on the anxiety of mothers with preterm infants. Methods: In this experimental research, 140 samples were selected based on inclusion criteria using a convenience sampling method and then put in two groups of back massage and one control group. The tools for collecting the data were demographic questionnaire and Lehrer & Woolfolk's somatic, cognitive, and behavioral anxiety inventory. The data were analyzed using descriptive (Mean±SD) and inferential statistics tests (Chi-square, independent t-test, paired t-test, Fisher, and covariance analysis) by SPSS V. 13. Results: The mean scores of somatic, cognitive, and behavioral anxiety components showed significant differences before and after the intervention in the massage group (P

BACKGROUND AND OBJECTIVE: Due to lack of physical, emotional and psychological preparation, premature birth may cause a lot of stress for parents and may have consequences for both parents and infants. Since some parents have difficulty participating in face-to-face training programs, this study was conducted to determine the effectiveness of a training program based on virtual participation on stress and anxiety of parents with premature infants METHODS: This quasi-experimental study was performed among 80 parents of premature infants admitted to Amirkola Children's Hospital and Ayatollah Rouhani Hospital, who were randomly assigned to intervention and control groups with 40 participants in each group. The parents of the intervention group received the content of the virtual participation training program asynchronously in the form of Telegram groups within four days. The control group received no intervention other than the usual methods and support of the ward. Then, the State-Trait Anxiety Inventory (score 40-160) and the Parental Stress Scale (score 31-155) were completed and compared on the third and seventh days for both groups and on 13th day for the intervention group. FINDINGS: Results showed that parental stress score decreased from (97.118±21.68) to (86.27±00.27) (p

Background: Previous studies have considered patent ductus arteriosus (PDA) a common finding in premature infants, leading to complications such as intracranial hemorrhage, necrotizing enterocolitis and pulmonary dysplasia. The aim of this study was to assess and compare the efficacy of oral ibuprofen and intravenous acetaminophen in the closure of arterial duct in premature newborns. We also evaluated the complications of each drug. Methods: A cross-sectional and analytical study was conducted at Amiralmomenin Hospital, Semnan City in Iran from April 2012 to December 2017. Subjects were selected through convenient sampling and consisted of all premature infants with patent arterial duct. All of the infants with the diagnosis of PDA were treated with either intravenous acetaminophen or oral ibuprofen. Cardiac echocardiographic findings were assessed in two study groups before and after each treatment course. The complications associated with the two treatment approaches were evaluated in two groups after treatment of each drug. Results: In general, twenty-four neonates (62.5% females) with the average gestational age of 31.46±3.43 weeks were studied. There was no significant difference in the echocardiographic characteristics in the two treatment groups at the pre and post-treatment periods as well as the side effects of the medications. The average number of treatment cycles in newborns treated with oral ibuprofen (1.06±0.25) was not significantly different compared to those with intravenous acetaminophen (1.25±0.46) (P=0.190). There was no significant difference concerning closure status of the arterial duct in the two treatment groups at the end of the first period (P=0.112) as well as after the second period of treatment (P=0.386). Conclusion: Our study indicated similar efficacy of oral ibuprofen and intravenous acetaminophen in the closure of the arterial duct. The incidence of complications was not significantly different between the two groups. The results of this study suggest the use of intravenous acetaminophen as a suitable drug for PDA closure, particularly in cases of ibuprofen contraindications.

Introdution: Newborn individualized developmental care and assessment program (NIDCAP) is emphasized. This study aimed to determining the barriers to implementation of NIDCAP from nurses' perspectives in neonatal intensive care units in Shahid Sadoughi Hospital in Yazd. Methods: This descriptive study was conducted using a census sampling method. The samples were54 nurses working in the intensive care unit of Shahid Sadoughi and Afshar Hospitals in Yazd. Data were gathered using two questionnaires,( demographic and barrier assessment questionnaires) . Data analysis was performed in SPSS version 24 using descriptive statistics, Chi-square, independent t-test and fisher test. Results: Results showed that in terms of mean and standard deviation, in the area barriers of sleep care, lack of skill (3.08± 1.28 ), In the area of pain and stress assessment management, lack of skill (2.86. ±1.31), in the area of activities of daily living and family-centered care, lack of effective communication with parents respectively (2.83 ± 1.39) and ( 2.86± 1.32), in the area of provision of healing environment, lack of standard light and sound in unit (2.76 ± 1.81) and in the area of organizational barriers, the disproportionate number of nurses to the patients (3.47±0.84) were identified as the most important barriers Conclusion: Based on the findings, lack of skill, lack of effective communication with parents, lack of standard environment and disproportionate number of nurses and patients are the most important barriers to the implementation of NIDCAP in NICUs that managers need to plan appropriate design for addressing them.

Background and Objectives: One of the causes of neonatal death and death in children under the age of five is premature birth of infants. The purpose of this study was to identify the risk factors associated with preterm infant birth in pregnant women. Methods: This is a case-control study on mothers referring to comprehensive health centers in the provinces of the country. Descriptive analysis of variables was reported as percentage and frequency. In data analysis, logistic regression analysis was used at a significant level less than 0.05. Results: In this study, 2463 pregnant women (668 cases as cases and 1795 as controls) were examined. There was a significant relationship between the place of residence (OR=0.702, P=0.002), level of maternal education (OR=1.920, P=0.027), degree of twin (OR=4.953, P=0.001), interval between pregnancies (OR=1.821, P=0.009), specific disease (OR=1.694, P=0.010), nutritional status of the mother (OR=1.420, P=0.024), physical activity (OR=1.591, P=0.001), Sleep patterns (OR=0.634, P=0.008) and history of stillbirth (OR=0.247, P=0.001) associated with the birth of premature infants. Conclusion: Preterm infant birth is one of the main causes of neonatal death. Therefore, some of the birth defects of the premature baby can be prevented. It is possible to reduce the risk factors for the birth of a premature baby by improving the quality of pregnancy care and changing the lifestyle of the pregnant mother, and by raising awareness and creating a healthy and safe environment for the mother.

Background: With the increase in the number of premature neonates, there are concerns about the complications of this group. One of the common complications of preterm neonates is fungal sepsis. Therefore, this study was conducted to evaluate the efficacy of intravenous fluconazole on fungal sepsis and other complications related to premature newborns under 1200 g in a neonatal intensive care unit. Methods: The study was conducted by field trial. The intervention included intravenous injection of fluconazole (3 mg/kg, twice per week for 6 weeks) in neonates weighing less than 1200 gr in the Izadi Hospital in Qom, Iran. The intervention was conducted on September 2016 in entire population of the study. The control group was retrospective and from neonates admitted to Izadi Hospital, which were hospitalized before intervention. The outcomes (such as the need for amphotericin injection, death, fungal sepsis, time taken to reach enteral feeding and length of stay) were compared between the two groups. Results: There was no significant difference between the two groups regarding their sex ratio (P=0.139), gestational age (P=0.834), type of delivery (P=0.841) and birth weight (P=0.458). After the intervention, fungal sepsis (from 65% to 48.3%) and the need for amphotericin injection (from 27.1% to 5%) were significantly reduced, and the mortality rate decreased from 40% to 28.3%, but this decline was not statistically significant (P=0.178). After the intervention, the length of stay in hospital (P=0.142) and neonatal intensive care unit (P=0.422), time to reach the weight of 1500 gr (P=0.717), and time taken to reach enteral feeding (P=0.289) did not change significantly. Proportion of pneumothorax, apnea, necrotizing enterocolitis, retinopathy of prematurity and need for respiratory support did not change significantly. Conclusion: The present study showed that administration of venous fluconazole could reduce fungal sepsis in neonates weighing less than 1200 grams in the intensive care unit. However, this study failed to demonstrate the effect of fluconazole on death, pneumothorax, apnea and need for respiratory support.

According to medical science data, "infants" have a special Stahrs in terms of breastfeeding and custody, which has made the role of mothers in their health irreplaceable. Mother's milk for premature infants is associated with the characteristics of urgency and necessity and exclusivity; Therefore, the confrontation of the mother's religious duties towards the baby and her religious responsibilities towards her husband is inevitable and is considered as a kind of jurisprudential challenge. In this descriptive-analytical study, the obligation of breastfeeding with the first title and the sufficient obligation of custody for the mother as well as the criteria of inconsistency show that although a general ruling is not possible and the case needs a case study, in most cases, the mother's duties to the baby Immature is legally preferable. Considering the exclusion of the subject from the inclusion of no harm and no wrong (la haraj) rules and the absence of explicit preference from the texts in this chapter, it is important to discover the verdict based on the preference of the chapter of conflict(tazahorn) and the rules of important and more important(كبج and mohemh. [ABSTRACT FROM AUTHOR]

Introduction: One of the most important causes of death in premature infants is nosocomial infections, and skin can be one of the ways of infections enter to the body. Considering the role of sunflower oil with massage in reducing nosocomial infections, the present study was performed with aim to determine the effects local sunflower oil on the prevention of nosocomial infections in premature infants. Methods: This clinical trial was performed in 2016 on 60 premature infants (less than 34 weeks of gestation) admitted to the NICU department of Ghaem Hospital in Mashhad. The subjects were placed in two groups: sunflower massage (n=27) and control group (n=33). The body surface of these infants was covered with sunflower oil three times a day for 2 weeks and then twice for up to 28 days. When the baby is getting sick, blood counts, platelet count and white blood cells were measured. Also, after oiling the skin, the skin condition was evaluated on days 1, 3, 7, 14, 21 and 28. Data were analyzed by SPSS software (version 21) and with t-test and Chi-square test. P

Background and purpose: Preterm birth is a stressful situation for parents and the infant, which may lead to difficulties in mother-infant relationships and disturb emotional and cognitive development in infants. The purpose of this study was to investigate the factorial structure, validity, and reliability of the Parenting Stress Scale for Mothers of Premature Infants. Materials and methods: The research sample included 500 mothers of premature infants selected via convenient sampling. They were divided into two groups (n=250 per group). Cronbach's alpha coefficient was used to evaluate the reliability of the scale. Exploration and confirmation factor analysis were applied to investigate the validity of the scale. Results: The Parenting Stress Scale for Mothers of Premature Infants was found to have an acceptable internal consistency and the Cronbach's alpha coefficient was 0.918. Test-re test reliability coefficient was 0.833 after 15 days. Three factors of parenting stress, mother-infant turbulent interaction, and parental expectations were obtained under the varimax rotation. The exploratory and confirmatory factor analysis also confirmed that the structure of the scale had an acceptable fit to the data, and all indicators confirmed the fitting goodness of this model. Conclusion: Findings showed that this scale has appropriate psychometric properties which could be suitable in evaluating parenting stress for mothers of premature infants

Background: One of the important effects of kangaroo mother care (KMC) in preterm baby is improvement in weight gain and so shortening in hospitalization, but it is not clear that how long of kangaroo mother care is effective in weight gain. The aim of this study was to determine the least effective duration of kangaroo mother care in weight gain in very low birth weights. Methods: Preterm babies with birth weight less than 1500 gr, without chronic cardiopulmonary disease, congenital anomaly and other medical problem when receiving to 140 ml/kg/d enteral feeding enrolled the study. KMC was started when the baby has been stabled, on the mother’s appetency and ability at bedside. The mean daily weight gain in KMC period was compared with expected that (15 mg/kg/d) for the same baby. The babies with KMC≥ 7 days were divided in three groups on the basis of mean daily KMC duration (< 30 min, 30-60 min and> 60). Statistical study performed by using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and P values of less than 0.05 were considered to be significant. Results: In this study, 103 preterm baby (47 boys, 56 girls) less than 1500 gr were enrolled, with mean birth weight 1107.85±190.87 gr. Mean weight gain of boys in KMC period and expected that were 324.78±162.66 gr Vs. 127.46±54.66 gr (P< 0.001). In eighty-seven babies who received KMC (7-40 days) mean daily weight gain was 26.69±15.55 gr (P< 0.001). Mean weight gain in KMC period for group with< 30 min (n=19), 402.63±126.29 gr Vs. 167.21±74.20 (P< 0.001), group with 30-60 min (n=54) were 338.79±182.60 gr Vs. 220.36±66.98 (P< 0.001) and group with 60< (n=14) 352.14±236.02 gr Vs. 259.96±112.23 (P= 0.09). Conclusion: On the basis of this study KMC less than 1 hour per day is effective in weight gain of very low birth weight preterm babies.

Background & Aim: Tracheal suctioning is one of the ways to clean and open the airway in infants admitted to the neonatal intensive care unit that can be with many negative consequences such as pain, decrease in arterial oxygen saturation, pneumonia, heart rhythm disorder, change In the rhythm and number of respiration and sepsis. Materials & Methods: This is a descriptive correlational study with IR.UMSHA.REC.1395.424 ethical code, was performed on 120 preterm infants in neonatal intensive care unit of Besat and Fatemieh Hospitals of Hamedan. Firstly, before suctioning the patient, the heart rate index of the newborn that needed to be suctioned was registered by the researcher in three shifts based on the findings of the direct monitoring of the infant. The heart rate index was re-recorded during suction. Data were analyzed using descriptive and regression tests. Results: Infants with a catheter of 6 to 9 french were suctioned at 80 to 85 suction pressure. In 26% of cases, the suctioning standards for the duration of suction, standard pressure and proper size of the catheter were not observed. There was a significant difference between the change in heart rate index and pain score (P=0.001). Conclusion: Failure to observe suction standards in premature infants can lead to changes in heart rate index and increase their basic needs, which can impair the recovery process of preterm infants.

Introduction: More than half a century, studies reported about strong association between preterm birth and development disorders. Therefore, the aim of this study was to follow the effect of a period of tactile kinetic simulations on motor development quotient in preterm neonates. Materials and Methods: So, among all of Iranian neonates healthy and preterm of Amiralmomenin hospital neonatal unit of Semnan city, 40 neonates selected purposefully and divided into experimental and control groups (20 person each group). Then, mothers of the experimental group conducted tactile kinetic stimulations on neonates to completion of the fetal period (40 weeks gestation) for 20 minutes and three times a day whereas the control group received only usual care. Peabody Development Motor Scale test was used to measure motor development quotient. Results: The results showed that tactile kinetic stimulations led to significant improvement in motor development quotient of neonates in the experimental group as measured in the end of intervention and after 4 months compared to the control group. Conclusion: It can be concluded that tactile kinetic stimulation can allow cost and stable way in order to increase motor development of preterm infants. [ABSTRACT FROM AUTHOR]

Background: Premature infants undergo a lot of stressors during treatment procedures in the neonatal intensive care units which causes significant physiological changes in these neonates. Multi-sensory stimulation is a broad category of interventions designed to improve the evolutionary and physiological outcomes of premature infants hospitalized in the neonatal intensive care unit to minimize stress in this environment. So, the study aimed to evaluate the effect of multi-sensory stimulation on physiological parameters in preterm infants. Methods: This double-blind clinical trial conducted in the neonatal intensive care unit of Shahid Motahari Hospital in Jahrom from April to December 2016. In this study, 80 preterm infants with a gestational age of 34 to 36 weeks were selected by nonprobability sampling method and were randomly divided into two groups of multisensory stimulation and control. Neonates in the intervention group received a multisensory stimulation program for 60 minute. The multi-sensory stimulation program was included a combination of auditory, tactile, motor and visual stimulation. The preterm infants in the control group received only usual care. The data collecting tool was a questionnaire and checklist for physiological parameters of preterm infants. Results: The results showed that the two groups were homogeneous in terms of fetal age, birth weight, the height of birth, first and fifth minute Apgar score of birth. The results showed that there was no significant difference between the mean of physiological indexes in the two groups before the intervention. Statistical tests showed that there was a decreasing trend in the average of all physiological indices during the intervention (first and second half during the intervention) (P<0.001), However, these changes were not significant in the control group (P<0.05). Also, analysis of variance (ANOVA) with repeated measures showed that there was a significant difference between changes in physiological variables between the two groups at different stages of evaluation (P<0.001). Conclusion: Multi-sensory stimulation leads to a decrease in heart rate and respiratory rate and the stability of blood pressure in preterm infants. [ABSTRACT FROM AUTHOR]

Introduction: Hyaline membrane disease (HMD) is one of the most common respiratory diseases in preterm infants. The main cause of the disease is surfactant deficiency and its clinical symptoms include respiratory distress tachypnea, cyanosis, granulation, and increased oxygen demand. There are generally two methods of administering surfactants, 1- prophylactic 2- Rescue. This study aimed to evaluate the effect of gastric aspiration impulse test on predicting the need for surfactant in neonates. Materials and Methods: This study was a descriptive-analytic study in which all newborn infants less than or equal to 34 weeks of age had respiratory distress and clinical symptoms of hyaline membrane disease such as granitic, cyanosis, intraretinal retraction. And sub-ribs were studied and causes other than those listed are exclusion criteria and excluded. The sampling method was easy and data were collected from an oral interview of pregnant mothers, checking the files and completing the questionnaire. Data analysis software was SPSS v21 and descriptive statistics and regression tests were used for odds ratios. Results: In this study, 62 (68.1%) neonates were male and 29 (31.9%) were female. The mean birth weight of neonates was 1662±593 g and their mean age was 31.7±2.5 weeks. Normal delivery and cesarean section in this study were 35 (38.5%) and 56 (61.5%), respectively. According to the findings, diabetes mellitus had a significant relationship with hyaline membrane disease. Hypertension, addiction, corticosteroid administration, and gender were also significantly associated with membrane disease (P <0.05). According to the present study, there was no significant relationship between the type of delivery and hyaline membrane disease (P> 0.05). Conclusion: Our study showed that the offspring of mothers with hypertension, addiction, and diabetes were less likely than others to have membrane disease and need to be given surfactants. The administration of corticosteroid drugs to mothers is also associated with the development of hyaline membrane disease. [ABSTRACT FROM AUTHOR]

Background: Putting infants in a posture that reduces oxygen requirement and the complications of the continuous positive airway pressure method is very important. This study aimed at examining the effect of the posture on the arterial oxygen saturation, fraction of inspired oxygen (FIO2) and abdominal distension in premature infants with the respiratory distress syndrome under nasal continuous positive airway pressure. Materials and Methods: In this clinical trial study, 41 premature infants were selected by the simple random sampling and one-group before-after design. The amounts of arterial oxygen saturation, FIO2 and abdominal distension in supine and prone positions were recorded in a data-collection form. Results: There was a significant difference between the mean FIO2 and between the mean abdominal circumference in the prone and supine positions (P=0.022, P

BACKGROUND AND OBJECTIVE: Noise is the most common environmental stressor source for premature infants admitted to the neonatal intensive care unit. Venous sampling is one of the most painful-causing actions in newborns. The aim of this study was to determine the effect of voice loss using ear protector on pain caused by intravenous sampling and heart rate of premature infants. METHODS: This randomized clinical trial study was performed on 112 premature infants aged between 36 and 28 weeks who were randomly divided into two groups of intervention (56 subjects) and control (n=56). The ear protector was used for the intervention group when the baby was subjected to intravenous sampling. Neonatal pain was measured by PIPP instrument (premature infant pain measuring instrument) in five steps (2 minutes before the needle penetration), (moment of needle penetration), (pump time), (moment of needle withdrawal) and (5 minutes after needle withdrawal). Heart rate was measured with a pulse oximeter (8 times every 30 minutes during 4 hours after using the ear protector) and compared. (IRCT: 2015210828925N1). FINDINGS: The mean changes in PIPP score were in the intervention and control groups (1.6±5.6 and 4.6±1.6), second (12.1±3.3, and 12.6±2.8), third (13.5±2.7 and 13.4±2.9), fourth (6.4±2.6 and 8.5±2.8), and fifth (5.1±4.2) and 1.6±6.2) respectively. Scores in all states except for the second and third stages were statistically significant in both groups (p

BACKGROUND AND OBJECTIVE: The birth of a premature infant is associated with long – term hospitalization and separation from family. Hospitalization of the infant affects the attachment between the infant and mother and affects the quality of care given to the infant by mother and increases the risk of delayed behavioral problems. Therefore, the present study aims to analyze the effect of family-centered care program on maternal attachment in mothers of premature infants. METHODS: In this clinical trial, 60 mothers of premature infants with gestational age of 30 to 36 weeks, hospitalized in neonatal intensive care unit of Motahari Hospital were selected using convenient non-probability sampling and were randomly divided into two groups of control and intervention (30 mothers in each group). The family-centered care program was performed on intervention group in three steps: In the beginning of infant care, before the fourth day of hospitalization and before discharge, while the control group was only under the usual care. The level of maternal attachment was measured using Avant's mother-infant attachment behavior questionnaire and each dimension of attachment behavior was scored from 0 to maximum based on care (45), proximity (45) and emotional (37) behavior (IRCT: 2017021914454N3) FINDINGS: The total score of maternal attachment increased from 34.3±5.1 to 61.6±4.5 in intervention group and increased from 33.1±4.2 to 37.8±3.7 in control group. There is a significant difference between the two groups in terms of total score of attachment between mother and premature infant (p

Background: Previous studies have considered patent ductus arteriosus (PDA) a common finding in premature infants, leading to complications such as intracranial hemorrhage, necrotizing enterocolitis and pulmonary dysplasia. The aim of this study was to assess and compare the efficacy of oral ibuprofen and intravenous acetaminophen in the closure of arterial duct in premature newborns. We also evaluated the complications of each drug. Methods: A cross-sectional and analytical study was conducted at Amiralmomenin Hospital, Semnan City in Iran from April 2012 to December 2017. Subjects were selected through convenient sampling and consisted of all premature infants with patent arterial duct. All of the infants with the diagnosis of PDA were treated with either intravenous acetaminophen or oral ibuprofen. Cardiac echocardiographic findings were assessed in two study groups before and after each treatment course. The complications associated with the two treatment approaches were evaluated in two groups after treatment of each drug. Results: In general, twenty-four neonates (62.5% females) with the average gestational age of 31.46±3.43 weeks were studied. There was no significant difference in the echocardiographic characteristics in the two treatment groups at the pre and posttreatment periods as well as the side effects of the medications. The average number of treatment cycles in newborns treated with oral ibuprofen (1.06±0.25) was not significantly different compared to those with intravenous acetaminophen (1.25±0.46) (P=0.190). There was no significant difference concerning closure status of the arterial duct in the two treatment groups at the end of the first period (P=0.112) as well as after the second period of treatment (P=0.386). Conclusion: Our study indicated similar efficacy of oral ibuprofen and intravenous acetaminophen in the closure of the arterial duct. The incidence of complications was not significantly different between the two groups. The results of this study suggest the use of intravenous acetaminophen as a suitable drug for PDA closure, particularly in cases of ibuprofen contraindications. [ABSTRACT FROM AUTHOR]

Background: With the increase in the number of premature neonates, there are concerns about the complications of this group. One of the common complications of preterm neonates is fungal sepsis. Therefore, this study was conducted to evaluate the efficacy of intravenous fluconazole on fungal sepsis and other complications related to premature newborns under 1200 g in a neonatal intensive care unit. Methods: The study was conducted by field trial. The intervention included intravenous injection of fluconazole (3 mg/kg, twice per week for 6 weeks) in neonates weighing less than 1200 gr in the Izadi Hospital in Qom, Iran. The intervention was conducted on September 2016 in entire population of the study. The control group was retrospective and from neonates admitted to Izadi Hospital, which were hospitalized before intervention. The outcomes (such as the need for amphotericin injection, death, fungal sepsis, time taken to reach enteral feeding and length of stay) were compared between the two groups. Results: There was no significant difference between the two groups regarding their sex ratio (P=0.139), gestational age (P=0.834), type of delivery (P=0.841) and birth weight (P=0.458). After the intervention, fungal sepsis (from 65% to 48.3%) and the need for amphotericin injection (from 27.1% to 5%) were significantly reduced, and the mortality rate decreased from 40% to 28.3%, but this decline was not statistically significant (P=0.178). After the intervention, the length of stay in hospital (P=0.142) and neonatal intensive care unit (P=0.422), time to reach the weight of 1500 gr (P=0.717), and time taken to reach enteral feeding (P=0.289) did not change significantly. Proportion of pneumothorax, apnea, necrotizing enterocolitis, retinopathy of prematurity and need for respiratory support did not change significantly. Conclusion: The present study showed that administration of venous fluconazole could reduce fungal sepsis in neonates weighing less than 1200 grams in the intensive care unit. However, this study failed to demonstrate the effect of fluconazole on death, pneumothorax, apnea and need for respiratory support. [ABSTRACT FROM AUTHOR]

Introduction: Milk intolerance is a common problem in a preterm neonate with low birth weight, which resu lts in the need to feed through the vessel with its many complications. Erythromycin is an antibiotic with prokinetic properties that can have beneficial effects in the treatment of this disorder. This study was performed to evaluate the effect of moderate dose erythromycin on the treatment of intolerance to nutrition in preterm infants. Materials and Methods: In this randomized clinical trial, the neonates were randomly divided into two groups receiving erythromycin (20 mg/kg/day) or placebo, and the number of cases of milk intolerance (milk lavage), milk filling time, necrotizing enterocolitis, duration of hospitalization, probable complications of erythromycin, such as hypertrophic pyloric stenosis, and other cases were compared in both groups. Results: 64 preterm infants with the mean gestational age of 30.1 ± 2.49 weeks were studied. The number of milk intolerance and the mean milk filling time (150 cc/kg/day) were significantly lower in the erythromycin group than in the control group (P<0.05). Other variables were not significantly different between the two groups of erythromycin and placebo (P>0.05). Conclusion: Erythromycin with a moderate dose was effective in reducing the incidence of milk intolerance and improving the mean time to reach the full volume of milk in premature neonates with low birth weight, and it appeared to be a safe drug for these neonates. [ABSTRACT FROM AUTHOR]

Background: Premature birth is a major cause of infant mortality in developed countries. Newborns confined to neonatal intensive care units (NICUs) are in a rapid stage of brain development. As such, sleep plays a pivotal role in the proper brain development of newborns. However, this developmental aspect is often disregarded due to the lack of information. Aim: This study aimed to evaluate the effect of nest posture on the sleep-wake state of premature infants. Method: This cross-over clinical trial was conducted on 60 premature infants admitted in the NICU of Ghaem Hospital in Mashhad, Iran in 2015. Infants were divided into two groups of experimental and control. Data were collected using the Assessment of Premature Infants' Behavior (APIB). Neonates in the control group were placed in an incubator, and neonates in the experimental group were positioned in a nest. Between-group comparison was performed using paired-samples T-test for normal variables and Wilcoxon test for non-normal variables. Results: In this study, no statistically significant differences were observed between the two groups in terms of the scores of deep sleep state before (P=0.50) and after the intervention (P=0.59). However, during the intervention, mean score of deep sleep was higher in the experimental group (P=0.08). Moreover, mean score of slow wake state had no significant difference between the study groups before (P=0.67), after (P=0.86), and during the intervention (P=0.81). Implications for Practice: According to the results of this study, nest posture increased the deep sleep hours of premature infants as the most imperative state of brain development. Therefore, it is recommended that nest posture be used to improve the deep sleep state of premature infants.

Background & Aim: Although mechanical ventilation is a life-saving intervention for many infants with respiratory distress syndrome, it carries potential complications. One of these complications is prolonged duration of mechanical ventilation. More than 15 days of mechanical ventilation is associated with increased risk of cerebral palsy and attention deficit hyperactivity disorder among extremely low birth weight infants. The current study aimed to determine the relationships between the length of mechanical ventilation and its related factors in neonates with respiratory distress syndrome. Methods & Materials: In this analytical study, a convenience sample of 60 premature infants of 33 weeks’ gestation or less with respiratory distress syndrome was recruited from three hospitals (Mahdieh, Mofid, and Imam Hossein) affiliated to Shahid Beheshti University of Medical Sciences in 2014-2015. Then, factors related to the length of mechanical ventilation such as sex, type of birth, birth weight, gestational age, Apgar score at the first minute, Apgar score at the fifth minute were assessed. The data were analyzed using descriptive statistics, Pearson correlation, independent t-test, and multiple regression analysis on SPSS software v.20. Results: The mean gestational age was 30.62±1.8 weeks and the mean weight of infants was 1510.33±390.940 grams. The mean length of mechanical ventilation was 3.58±2.97 days. There were not any correlations between sex, type of birth and the length of mechanical ventilation (P>0.05). Gestational age and weight were significantly correlated to the length of mechanical ventilation (P

Background and Aim: premature birth and its caring is a stressful period which significantly affects the quality of parent’s life especially the mother. A study was conducted to compare the quality of life of mothers of premature infant and full-term infant. Methods: This case-control study was conducted in health centers of Sanandaj city in 2013. The participants were 50 mothers with premature infant as intervention group and 50 mothers with full-term infant as the control group.In order to collect data, researcher made demographic questionnaire and the 36 item quality of life of WHO were used. Data analysis was performed using the software spss17. Findings: The demographic characteristics of the mothers in both groups were not statistically significant. Mothers of premature infant have a lower quality of life scores in the areas of health, social relations and the total score compared with mothers of full-term infant (P=0/001). In the area of environmental health and mental health the mean of quality of life scores in the two groups showed no significant difference (P = 0/715). Conclusion: considering the low quality of life of mothers of premature infant, health care providers should be sensitive towards the educational and emotional needs of these mothers so that necessary intervention could be done during caring of their infant.

BACKGROUND AND OBJECTIVE: With the advancement of medical care procedures, survival rate of preterm neonates has increased remarkably. In Iran, few studies have assessed the extent and severity of developmental disorders in these infants. This study aimed to evaluate developmental disorders in premature neonates. METHODS: This cohort study was conducted on 270 premature infants born in Ghaem Hospital in Mashhad, Iran with mean birth weight of 1460±40 grams. Data on pregnancy, parturition and complications during hospitalization were recorded. Moreover, preterm neonates were evaluated in terms of developmental delay at 6, 12, 18 and 24 months of age based on the Ages and Stages questionnaire (ASQ). FINDINGS: In this study, symptoms of developmental delay were observed in 152 neonates (56%) at six months, 115 neonates (42.7%) at 12 months, 101 infants (37.5%) at 18 months, and 49 neonates (18%) at 24 months. In addition, abnormal development was detected in different areas, including communication (n=21, 7.8%), major movements (n=53, 19.6%), minor movements (n=74, 27.5%), social interactions (n=89, 33%), and problem solving (n=153, 57%). After a two-year follow-up, 27 infants (60%) had asphyxia, 29 (28%) had respiratory distress syndrome, and 20 infants (15%) had developmental disorders. CONCLUSION: According to the results of this study, about one-sixth of preterm neonates had developmental delay at two years of age. The highest rate of developmental disorders was observed in the area of problem solving, which should be taken into account in neonatal rehabilitation services. On the other hand, appropriate monitoring of neonatal asphyxia and jaundice is likely to reduce the risk of other complications during infancy

Abstract Background & Aims: Respiratory diseases are the common cause of hospitalization of preterm infants in neonatal intensive care unit. Although mechanical ventilation has saved many infants' lives, like other treatments; it has not been without harm. Developmental care intervention is a potential method for reducing the duration of mechanical ventilation in infants. The aim of this study was to determine the effect of developmental care interventions on duration of mechanical ventilation in preterm infants with respiratory distress syndrome. Material & Methods: This quasi-experimental non-randomized study was conducted on 60 preterm infants of gestational age ≤33 weeks with respiratory distress syndrome who were divided into intervention and control groups. Infants in the control group received routine nursing care, and those in the intervention group received developmental care as well as routine care. Results: Mean duration of ventilation was 3.63±2.94 days in control group and 4.06±3.05 days in intervention group, with no significant difference between the two groups (P=0.57). Conclusions: According to the results obtained, developmental care interventions had no effect on duration of mechanical ventilation in preterm infants with respiratory distress syndrome.

Abstract Background & Aims: The life of preterm infants admitted to a Neonatal Intensive Care Unit (NICU) is stressful from the moment of birth. In order to reduce the stress imposed on these infants clustered care is recommended. The aim of present study was to compare the physiological responses of preterm infants to clustered care with three and five noninvasive procedures. Material & Methods: This study was a randomized crossover clinical trial. Thirty one preterm infants were studied at 32 weeks age by clustered care with three and five procedures. Primary outcomes such as heart rate, respiratory rate and blood oxygen saturation were assessed. Data analysis conducted with a mixed model method at 0.05 significant level. Results: The findings showed that the mean of oxygen saturation on before, during and after clustered care with three procedures were respectively 97.52, 97.32, 97.84 and in clustered care with five procedures were 97.68, 97.94, 97.65. Heart rate of three procedures were 146.26, 149.90, 149.97 and five procedures were 150.61, 154.77, 154.65. Respiratory rate of three procedures were respectively 51.68, 48.87, 47.71 and five procedures were 49.10, 48.61, 49.48. All of these physiological responses were at normal range. Significant differences were not found between physiological responses of two groups (P>0.05). Conclusion: Clustered care with three procedures is as same as clustered care with five procedures and both of them could be recommended for stable premature infants in 32 weeks.

Background: Birth of a premature neonate is associated with hospital admission and separation from the family. Admission of the neonates intervenes on infant-mother attachment and so adversely affects on the quality of care given by the mother, and subsequently increases the risk of delayed behavioral problems in the children. Aim: To assess the effectiveness of mother empowerment program on the premature infant-mother attachment. Methods: In this randomized clinical trial, 70 mothers of premature infants, admitted to the neonatal intensive care unit (NICU) of Omolbanin hospital of Mashhad in 2014, were divided into of intervention and control groups. The Empowerment program was a multi-step treatment program, in which information about the premature infants was provided to mothers through an illustrated booklet with a workbook and audio file in each step. Mothers in the control group received information and routine care according to the hospital guideline. The mother-infant attachment was measured after the intervention using the maternal and neonatal behaviors Avant tool. Data analysis was performed using chi-square and t-student tests by SPSS software version 11.5. Results:The mean scores of maternal attachment behaviors after the intervention in the empowerment and control groups were (56.62±8.06) and (39.51±7.77), respectively; the difference between the groups was statistically significant (P

Background and purpose: Preterm birth is a stressful situation for parents and the infant, which may lead to difficulties in mother-infant relationships and disturb emotional and cognitive development in infants. The purpose of this study was to investigate the factorial structure, validity, and reliability of the Parenting Stress Scale for Mothers of Premature Infants. Materials and methods: The research sample included 500 mothers of premature infants selected via convenient sampling. They were divided into two groups (n=250 per group). Cronbach's alpha coefficient was used to evaluate the reliability of the scale. Exploration and confirmation factor analysis were applied to investigate the validity of the scale. Results: The Parenting Stress Scale for Mothers of Premature Infants was found to have an acceptable internal consistency and the Cronbach's alpha coefficient was 0.918. Test-re test reliability coefficient was 0.833 after 15 days. Three factors of parenting stress, mother-infant turbulent interaction, and parental expectations were obtained under the varimax rotation. The exploratory and confirmatory factor analysis also confirmed that the structure of the scale had an acceptable fit to the data, and all indicators confirmed the fitting goodness of this model. Conclusion: Findings showed that this scale has appropriate psychometric properties which could be suitable in evaluating parenting stress for mothers of premature infants. [ABSTRACT FROM AUTHOR]

Background: One of the important effects of kangaroo mother care (KMC) in preterm baby is improvement in weight gain and so shortening in hospitalization, but it is not clear that how long of kangaroo mother care is effective in weight gain. The aim of this study was to determine the least effective duration of kangaroo mother care in weight gain in very low birth weights. Methods: Preterm babies with birth weight less than 1500 gr, without chronic cardiopulmonary disease, congenital anomaly and other medical problem when receiving to 140 ml/kg/d enteral feeding enrolled the study. KMC was started when the baby has been stabled, on the mother's appetency and ability at bedside. The mean daily weight gain in KMC period was compared with expected that (15 mg/kg/d) for the same baby. The babies with KMC≥ 7 days were divided in three groups on the basis of mean daily KMC duration (< 30 min, 30-60 min and> 60). Statistical study performed by using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and P values of less than 0.05 were considered to be significant. Results: In this study, 103 preterm baby (47 boys, 56 girls) less than 1500 gr were enrolled, with mean birth weight 1107.85±190.87 gr. Mean weight gain of boys in KMC period and expected that were 324.78±162.66 gr Vs. 127.46±54.66 gr (P< 0.001). In eighty-seven babies who received KMC (7-40 days) mean daily weight gain was 26.69±15.55 gr (P< 0.001). Mean weight gain in KMC period for group with< 30 min (n=19), 402.63±126.29 gr Vs. 167.21±74.20 (P< 0.001), group with 30-60 min (n=54) were 338.79±182.60 gr Vs. 220.36±66.98 (P< 0.001) and group with 60< (n=14) 352.14±236.02 gr Vs. 259.96±112.23 (P= 0.09). Conclusion: On the basis of this study KMC less than 1 hour per day is effective in weight gain of very low birth weight preterm babies. [ABSTRACT FROM AUTHOR]

Background & Aim: Technology advancement has increased the survival rates of premature infants. Preterm newborns frequently experience oral feeding difficulties due to lack of coordination in sucking, swallowing and respiration. This may negatively affect attainment of independent oral feeding skill and leads to longer hospital stays. This study aimed to examine the effects of non-nutritive sucking vs. oral massage therapy on attainment of independent oral feeding and length of stay in the NICU . Methods & Materials: This clinical trial was conducted on 72 premature infants (28-32 week gestational age) hospitalized in the NICU of Alzahra Hospital in Tabriz in 2013. The eligible infants were randomly allocated to one of the three groups: oral massage, non-nutritive sucking, and control groups. Newborn infants in the oral massage group received pre- and intraoral massage therapy (before gavage) for at least 10 days. The newborn infants in the non-nutritive sucking group were encouraged to suck on a finger of mother or the researcher before gavage. The control group received usual care. The time to attain independent oral feeding and length of stay in the hospital were compared in the groups . Results: Compared to the control group, the time to oral intake was significantly shorter in both experimental groups (P

Background & Aim: An important goal of nursing care in the Neonatal Intensive Care Unit (NICU) is to provide holistic care as well as the best possible outcome. Understanding perceived needs of mothers is valuable to achieve these goals. This study aimed to compare perceptions of nurses and premature infants’ mothers about mothers’ needs in the NICUs. Methods & Materials : This was a cross-sectional study in which 63 nurses and 63 mothers with premature infants were selected from the NICUs of four educational hospitals affiliated to the Mashhad University of Medical Sciences through stratified sampling method in two months. Data were gathered using the NICU Family Needs Inventory of Ward and were analyzed using descriptive-analytical statistical methods in the SPSS v.16. Results: Among the subscales related to family needs, the following items were reported to be important by mothers: Proximity (95.3%), Assurance (94.1%), Information (91.1%), Support (79.7%) and Comfort (72.8%). On the other hand, nurses believed that the following items were the most important needs of the mothers: Assurance (80.3%), Proximity (75.2%), Information (70.8%), Comfort (66.3%) and Support (64.8%). Conclusion : According to study findings, nurses should periodically assess needs of the mothers in the NICUs to be aware of the actual needs instead of placing subjective assumptions on mothers needs. This can improve effective communication and interaction with mothers and enhance satisfaction of the mothers with care.

Background: Pneumothorax is more common in neonatal period than the rest of the life. In term infants, pneumothorax is usually asymptomatic. However, premature neonates usually have symptoms particularly when they need mechanical ventilation. The aim of the present study was to investigate the prevalence and risk factors of pneumothorax among premature infants. Methods: This cross-sectional study was carried out in Alzahra and Shahid Beheshti University hospitals, Isfahan, Iran, in 2010. Neonates with gestational ages of 26-37 weeks hospitalized in neonatal intensive care unit (NICU) were included. Demographic features including gestational age, sex, and birth weight were collected. All neonates who had sudden changes in breathing status were evaluated for pneumothorax using chest X-ray (CXR). Data were analyzed using Student-t and χ2 tests. Findings: Among 303 studied neonates, 29 (9.6%) were suffered from pneumothorax. Birth weight, gestational age, number of pregnancy and mothers’ chronic diseases were significantly different in two groups (P < 0.001 for all). Chest compression, ventilation with bag and mask and needing intubation were statistically different between the two groups, too (P < 0.001). Conclusion: Premature neonates are at higher risk for pneumothorax due to lower birth weight, lower gestational age, higher number of mother's pregnancy, mother's diseases during pregnancy; also, interventions such as chest compression, ventilation with bag and mask and intubation procedure is more needed for them. Thus, many cautions during medical intervention must be done for prevention of pneumothorax .

Introduction: The correct development of sleep and wake immature states of premature infant has important role in maturation of brain but often, healthcare personnel neglect from this dimension of development and there are limited data about sleep and wake states of premature infant hospitalized in NICU. The aim of this study was to assessing the states of sleep and wake of premature infant and its relation with demographic variables. Materials & Methods:. In a descriptive-analytical study, 70 premature infant hospitalized in NICU constantly were selected based on the needed criteria. The sleep and wake state of infants were recorded with use of behavioral sleep and wake scale of Als. Scale validity was performed using its content analysis, translation, and reliability by Pearson coefficient. Results: The results showed that infants in sleep state had maximum rate of light sleep 3.65±3.27 and minimum rate of deep sleep 0.24±1.05 and in wake state had maximum rate of active awake 1.90±2.09 and minimum rate of quietly awake 0.18±0.68. Also Infants had states with stress 7.75±1.96 more than states without stress 3.65±3.27. Regression analysis showed no significant relation between gestational age and weight of infants with deep sleep and quietly awake. Conclusion: In this study premature infant were mostly in undesirable states of sleep and wake that this may lead to growing and developmental disorders of brain.

Background & Aims : Mothers’ involvement in the care of their premature infants is one of most effective ways to prevent disorders associated with hospitalization. This study aimed to determine mothers’ Performance on Caring for their Premature Infants in hospitals affiliated to Tehran University of Medical Sciences, during 2012. Materials & Methods : It was a descriptive , cross-sectional pilot study. First two hospitals affiliated with Tehran University of Medical Sciences which had NICUs were randomly selected and then 90 mothers of premature infants were recruited by convenience sampling. Data was collected using an observational checklist (including kangaroo mother care, massage, breast feeding, cup feeding and bathing) by two trained nurses and analyzed by descriptive statistics, chi- square tests and one-way analysis of variance using SPSS-PC (v. 16). Results : The mean age of the mothers was 27±1 with the range of 16-46 years old. The findings showed that 42.02 percent of mothers had poor performance, 41.16 percent had moderate performance and 16.82 percent had appropriate performance in the care of their premature babies. There were no significant relationship between mothers’ education, job, age, and infants’ weight and the mothers’ performance. There was not also a significant difference between birth order, the number of children and the mothers’ levels of performance (P>0.05). Conclusions: Regarding the findings, executing educational sessions on care of premature infants for their mothers in NICUs is recommended. More studies with larger samples are also required. Received: 13 Nov 2012 Accepted: 23 Jan 2013

Background & Aim: Premature infants undergo painful and stressful procedures during care and treatment. Nurses can help to reduce short- and long-term effects of pain caused by diagnostic and therapeutic procedures using various methods including music therapy. The aim of this study was to assess the effect of music therapy on physiological pain responses of premature infants during and after blood sampling. Methods & Materials: This was an experimental study with crossover design conducted on 20 premature infants hospitalized in the intensive care unit of a hospital affiliated to the Tehran University of Medical Sciences for a five months period in 2010-11. Infants were randomly allocated in two groups of experiment and/or control. Each infant was considered as its own control. We assessed the physiological pain responses caused by blood sampling such as heart rate and oxygen saturation level. Infants in the experiment group listened to the Transitions music five minutes before until 10 minutes after the blood sampling. The responses were recorded and reviewed ten minutes before until ten minutes after the blood sampling in both groups and physiological changes were detected. Data were analyzed using ANOVA and Chi-square tests in the SAS and SPSS. Results: Results showed significant difference in heart rate between the experiment and control groups during needle exit (P=0.022). There was also significant difference in heart rate between experiment and control group in the first 5 minutes of blood sampling (P=0.005). Conclusion: Results showed that music therapy could reduce some physiological responses of pain during and after blood sampling. Music therapy can be used as a beneficial intervention following painful procedures such as blood sampling in the NICU.