背景

既往研究证实了母亲的声音对新生儿生理结果的一些积极影响，而少有研究关注对皮质醇的影响。此外，最近发现白噪声对人类睡眠有益，但是对早产儿的研究非常有限，尚无研究比较母亲的声音和白噪声对早产儿的影响。

目的

在新生儿重症监护病房（NICU）中检查母亲的声音和白噪声对早睡模式，唾液皮质醇水平，体重增加，心率和血氧饱和度的影响。

方法

三组随机对照试验。2017年3月至12月间，从中国一家妇女儿童医院的新生儿监护病房（NICU）招募了103名具有医疗状况稳定的室早产儿，并随机分为三组：母亲的声音组（n = 34），白噪声组（n = 34）和常规护理组（n = 35）。母亲的声音，白噪声和无声音的声音连续20天每天一次提供给这三个小组，每次20分钟。母亲的声音和白噪声的声级控制在50至55 dB之间。在测试前和测试后分别测量睡眠-觉醒模式，唾液皮质醇水平和体重，而在连续四天的上午11点，下午2点，下午5点每五分钟测量一次心率和血氧饱和度。

结果

仅在体重增加上发现了组间差异（p = 0.003），白噪声组的体重增加显著高于母亲的语音组（Z = -3.447，p = 0.001）。仅在常规治疗组中，在测试前和测试后之间发现总睡眠时间和睡眠效率显著下降，并且睡眠开始后的醒来时间和平均觉醒时间显着增加（p <0.05）。三组之间的唾液皮质醇水平，心率和血氧饱和度水平无显著差异（p> 0.05）。在白噪声组中，在20分钟的干预过程中，氧饱和度显着增加。在所有这三组中，在20分钟的干预过程中心率均无显著下降，并且在测试后唾液皮质醇水平下降。

结论

与母亲的声音相比，白噪声对于鼓励早产儿体重增加更有用。可能引入白噪声用于新生儿重症监护室的早产儿护理，还需要更多高质量的随机对照试验来证实这些发现。

 

 

Background

A few positive effects of mothers’ voice on physiological outcomes have been studied and limited studies have focused on the level of cortisol. In addition, white noise has recently been found to be beneficial for human sleep, but studies in premature infants were limited and no study has compared the effects of mothers’ voice and white noise on premature infants.

Objective

To examine the effects of mothers’ voice and white noise on sleep-wake patterns, salivary cortisol levels, weight gain, heart rate, and oxygen saturation of premature infants in a neonatal intensive care unit (NICU).

Methods

This was a three-group randomized controlled trial. A total of 103 medically stable premature infants in incubators were recruited from the NICU of a women's and children's hospital in China between March and December 2017 and were randomized into three groups: the mothers’ voice group (n=34), the white noise group (n=34), and the routine care group (n=35). Mothers’ voice, white noise, and no voice were provided to the three groups for 20 minutes at a time, three times a day for four consecutive days. The sound levels of the mothers’ voice and white noise were controlled between 50 and 55 dB. Sleep-wake patterns, salivary cortisol level, and weight were measured at pre-test and post-test whereas heart rate and oxygen saturation were measured every five-minute at 11am, 2pm, 5pm for four-consecutive days.

Results

A group difference was found only in weight gain (p=0.003), with weight gain in the white noise group being significantly higher than the mothers’ voice group (Z=-3.447, p=0.001). Significant declines in total sleep time and sleep efficiency and increases in wake time after sleep onset and average awakening time were only found in the routine-care group between the pre-test and post-test (p<0.05). No significant differences were found in the salivary cortisol levels, heart rates, and oxygen saturation levels among the three groups (p>0.05). A significant increase in oxygen saturation during the 20-min intervention was found in white noise group. Non-significant decreases in the heart rate during the 20-min intervention and salivary cortisol levels at post test were noted in all the three groups.

Conclusion

White noise is more useful for encouraging weight gain in preterm infants compared with mothers’ voices. White noise might be introduced for use in the care of premature infants in NICUs, and more high-quality randomized controlled trials are needed to confirm these findings.

原文链接：

https://www.sciencedirect.com/science/article/abs/pii/S0020748921000754#!