Abstract
Objective An estimation of the individual's ability to cope with environmental adversity, that
is, stress resiliency, can be extrapolated by measuring cardiac vagal tone, that is,
high-frequency heart rate variability (HF-HRV); indeed, higher HF-HRV is associated
with health and developmental advantages for preterm neonates. Previous studies show
skin-to-skin contact (SSC) improves stress resiliency; however, linkages between SSC
and HF-HRV on outcomes have not been assessed. We aimed to test the hypothesis that
increased SSC frequency would enhance HF-HRV, reduce neonatal morbidity, and improve
developmental outcomes.
Study Design Weekly electrocardiograms and clinical data were obtained from 101 preterm neonates.
SSC frequency was determined from the electronic medical record.
Results At postnatal week 1, frequency of SSC and HF-HRV were positively correlated (p =.02); further, multiple stepwise regressions showed higher HF-HRV and SSC predicted
reduced days on ventilation and oxygen, and shorter hospital stay (p < 0.001). Higher HF-HRV predicted lower postmenstrual age (PMA) at discharge (p < 0.01).
Conclusion Higher SSC frequency was associated with increased HF-HRV during the first postnatal
week. SSC and HF-HRV uniquely predicted diminished neonatal morbidity throughout hospitalization.
Additionally, HF-HRV uniquely predicted earlier PMA at discharge. Augmenting SSC early
in life enhances stress resiliency and improves health outcomes.
Keywords
HF-HRV - preterm neonates - skin-to-skin contact - stress resiliency
