Preterm Infant Development, Preterm Infant Health
Conditions
Keywords
cycled light, preterm infants, infant neurodevelopment, infant sleep
Brief summary
Preterm babies cared for in the intensive care nursery are exposed to amounts of light that are very different from the exposures to an unborn baby or the newborn term baby. Currently many nurseries try to protect premature babies from too much light. They may also try to create light conditions of day and night like many parent homes. Some studies have shown improvements in health and development of babies cared for in nurseries that try to change light for premature babies.
Interventions
OTHERCycled Light
Cycled light was provided in an 11-hour-on, 11-hour-off pattern. Daylight (240-700 lux) was provided with the incubator cover folded on top of the incubator allowing light in from four sides, or with the bassinet cover off during day hours (0730-1830). With the daylight range of 240-700 lux and limited access to natural light, excessive daylight was prevented. Continuous near darkness was provided as (5-30 lux) throughout the day except from 0630-0730 and 1830-1930, when lighting levels varied based on nursing care needs at the change of shift. Near-darkness (5-30 lux) was provided by using incubator (totally covered or with the front flap back) and bassinet covers, and dimming individual bedside light during the day (0730-1830) and night hours (1930-0630).
Sponsors
National Institute of Nursing Research (NINR)
Duke University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
23 Weeks to 28 Weeks
Healthy volunteers
No
Inclusion criteria
* Infants were \< 7 days of age and were born at 28 weeks or \< 28 weeks
Exclusion criteria
* known anomalies associated with neurological or visual problems (e.g., congenital glaucoma, Down Syndrome)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Infant weight gain trajectory | weekly inpatient up to 52 weeks post menstral age (PMA) and at outpatient visits to 18 months | This measure was single blinded. |
| Change in sleep development during hospitalization | Every three weeks up to 52 weeks PMA | Change in the developmental pattern of four sleep wake states (active, quiet, transition, awake) were evaluated during hospitalization. |
| Change in sleep development after discharge home | Every 5 months following hospital discharge up to 24 months PMA | Change in the development of sleep and wake bouts were evaluated following hospital discharge until the infant reached 24 months PMA |
| Mental Development | 9 months PMA | Mental development was measured using the Bayley Scales of Infant Development. |
| Psychomotor Development | 9 months PMA | Psychomotor Development was measured using the Bayley Scales of Infant Development |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of Hospitalization in Days | At hospital discharge from 0 to 222 days | Length of hospitalization from birth until discharge home. |
| Change in Retinopathy of Prematurity (ROP) | Every two weeks during hospitalization after 30 weeks PMA up to 52 weeks PMA and during outpatient visits up to 24 months PMA | ROP change over time and degree of severity was assessed until 24 months PMA |
| Severity of Retinopathy of Prematurity (ROP) | Up to 52 weeks | ROP change over time and degree of severity was assessed until 24 months PMA |
| visual acuity | Measures at 12 months PMA | — |
| Neurological development | 9 months PMA | Neurological development was assessed by a neurological exam as either normal, suspect or abnormal and the presence of absence of Cerebral Palsy |
| Brainstorm Auditory Evoked Potentials | 6 months | — |
Outcome results
None listed