Contato precoce pele a pele entre mãe e recém-nascido pré-termo de 1000g a 1800g: repercussões sobre indicadores de estresse materno

Abstract

The impact of preterm birth tends to be emotionally stressful experience for most of the mothers who are susceptible to experience symptoms of anxiety and depression. Early maternal-infant separation may impair the attachment formation. The objective of this study is to investigate the influence of early skin-to-skin contact between mother and preterm infant with birth weight between 1,000 to 1,800 g on the repercussions of maternal stress. A randomized control study was performed in which the experimental group (n = 30) performed two sessions of skin to skin contact between 24 and 72 hours postpartum and control group (n=30) did not undergo exposure during this period. Transfontanellar ultrasound was performed before and after the exposure. This investigation would be interrupt if there was an increase in the incidence of intraventricular hemorrhage. Informations about maternal sócio-economic-demographic status, lifestyle, family relationships and pregnancy planning were investigated. Symptoms of anxiety (IDATE) - before and after exposure, and symptoms of postpartum depression (EPDS) -, on the seventh day after delivery and at four months' corrected gestational age of the preterm infants were evaluated. In the control group the anxiety symptoms were assessed between 24h and 72 hours postpartum. A reduction of 16.6% in the symptoms of moderate/severe anxiety after the second skin-to-skin contact was observed. However this difference was not statistically significant (p=0.166). A reduction of the symptoms of post-partum depression over time was observed in both groups, though it was significant just in the control group (p=0.005). On the seventh day after delivery and four months' corrected gestational age of the preterm infant it was not observed significant difference between groups (p=0.845, p=0.139, respectively). There was a loss to follow-up of 43.6 % of the sample and analysis of losses did not show statistically significant difference. Despite the small sample power and lack of statistically significant results, this research has sugested that maternal-preterm infant closeness is important to reduce maternal anxiety.