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Background: Preterm birth is associated with increased parental stress, worry, and anxiety, and affects parental-child interactional behaviour., Aim: To evaluate the influence of length of antepartum hospital stay on maternal stress after the birth of a preterm infant., Methods: A prospective two-centre pilot case-control study was performed at two tertiary level Neonatal-Intensive-Care-Units (NICU). Mothers of preterm infants <36 +0 weeks of gestation admitted to the NICUs were included. The stress of mothers with length of antepartum hospital stay <12h (n=20) were case-matched and compared to that of mothers with length of antepartum hospital stay ≥12h (n=20). Maternal stress was assessed within three days after birth with the Parental-Stress-Scale:NICU (PSS:NICU) questionnaire measuring three scales: "relationship and parental role", "sights and sounds", and "baby looks and behaves". Maternal socio-demographic data were collected by questionnaire administered at the same time., Results: Both groups of mothers had similar socio-demographic data. Stress scale of "sights and sounds" was significantly increased in mothers with antepartum stay ≥12h (2.48±0.69) compared to mothers with antepartum stay <12h (1.95±0.73) (p=0.024). There was no significant difference between the two groups regarding the "looks and behaves" (2.73±0.80 vs. 2.72±0.91; p=0.962) and "relationship and parental role" scales (3.31±1.08 vs. 3.58±1.18; p=0.484)., Conclusions: Our study demonstrated higher levels of maternal stress after preterm birth in mothers, who had been admitted to hospital for longer periods of time before delivery. Interventional programmes starting in the antepartum period should be established in order to reduce the burden of stress and to improve parental-child interaction., (Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Objective: To assess if monitoring of cerebral regional tissue oxygen saturation (crSO2) using near-infrared spectroscopy (NIRS) to guide respiratory and supplemental oxygen support reduces burden of cerebral hypoxia and hyperoxia in preterm neonates during resuscitation after birth., Study Design: Preterm neonates <34(+0) weeks of gestation were included in a prospective randomized controlled pilot feasibility study at 2 tertiary level neonatal intensive care units. In a NIRS-visible group, crSO2 monitoring in addition to pulse oximetry was used to guide respiratory and supplemental oxygen support during the first 15 minutes after birth. In a NIRS-not-visible group, only pulse oximetry was used. The primary outcomes were burden of cerebral hypoxia (<10th percentile) or hyperoxia (>90th percentile) measured in %minutes crSO2 during the first 15 minutes after birth. Secondary outcomes were all cause of mortality and/or cerebral injury and neurologic outcome at term age. Allocation sequence was 1:1 with block-randomization of 30 preterm neonates at each site., Results: In the NIRS-visible group burden of cerebral hypoxia in %minutes, crSO2 was halved, and the relative reduction was 55.4% (95% CI 37.6-73.2%; P = .028). Cerebral hyperoxia was observed in NIRS-visible group in 3 neonates with supplemental oxygen and in NIRS-not-visible group in 2. Cerebral injury rate and neurologic outcome at term age was similar in both groups. Two neonates died in the NIRS-not-visible group and none in the NIRS-visible group. No severe adverse reactions were observed., Conclusions: Reduction of burden of cerebral hypoxia during immediate transition and resuscitation after birth is feasible by crSO2 monitoring to guide respiratory and supplemental oxygen support., Trial Registration: ClinicalTrials.gov: NCT02017691., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To analyse impact of delayed cord clamping (DCC60sec) on cerebral regional tissue oxygenation (crSO2) and fractional tissue oxygen extraction (cFTOE) in spontaneously breathing preterm neonates during the first 15 min after birth., Methods: Two-centre observational study, crSO2 and cFTOE was monitored in neonates with DCC60sec or early cord clamping (ECC < 30 s)., Results: Seventy-six infants (birth weight and gestational age 1736 ± 508 g and 31.8 ± 2.5 weeks) were included. DCC was associated with lower initial crSO2 and higher cFTOE and lower initial Apgar-score and heart rate., Conclusion: Attending practitioners should be aware that DCC might impact initial immediate transition in spontaneously breathing preterm neonates.