Effect of nursery environment on state regulation in very-low-birth-weight premature infants

Abstract

Very-low-birth-weight (VLBW) neonates were observed in two different nursery environments from 32 to 36 weeks post conceptional age. Half of the subjects (n=12) were observed in a control environment and the other half (n=12) were placed in on alternative nursery environment more contingent on the infants' states and less stimulating than the control nursery. Subjects' spontaneous states and state-relevant behaviors were recorded by trained observers at the beginning and end of the 4-week period. These observations were used to measure state organization. We found a greater developmental change for infants in the alternative nursery. Infants in the alternative nursery group had longer state durations at 36 weeks and fewer state changes per hour. This indicates that a nursery environment with diurnal cycles, less intense unpatterned stimuli, and a priority of state-contingent nursing can promote steadiness and longer durations of sleep states in vulnerable preterm neonates.