Document Type : Original Article
Authors
1 Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
2 Neonatal Intensive Care Nursing, Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
3 Department of Pediatrics, Pediatric Growth and Development Research Center, Rasoul-e-Akram Medical Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
4 Neonatologist, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
5 Department of Neonatology, Ali Asghar Hospital, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
Abstract
Background: Support for evolutionary care of twin or multiple birth infants whose populations are rapidly growing is of considerable interest. Co-bedding has been considered as one of the evolutionary care strategies being implemented in many neonatal intensive care units (NICUs) throughout the world. This study is designed to investigate the effect of co-bedding among premature twin or multiple birth infants on their growth and physiological stability in a NICU with the largest number of births in Iran.
Methods: It is a randomized clinical trial performed on 80 pairs of premature twin infants hospitalized in the NICU of Shahid AkbarAbadi Hospital in Tehran, Iran. Patients were randomly allocated into the two groups; co-bedded and routine care. Data were collected through a demographic questionnaire and a co-bedding checklist and compared between the two groups.
Results: Data analysis showed that the weight gain and mean of NICU hospitalization days in the co-bedded group were significantly different from those of the standard care infants (P<0.001). However, there was no significant difference in terms of increase in height (P=0.1), head circumference (P=0.4), heart rate (P=0.3), arterial oxygen saturation (P=0.12), and respiratory rate (P=0.68) between the two groups.
Conclusion: On the basis of results, co-bedding could lead to better weight gain in twin birth infants and consequently accelerate their recovery and discharge.
Keywords
N. Systematic review of worldwide trends in assisted
reproductive technology 2004-2013. Reprod Biol Endocrinol.
2017;15(1):6. doi: 10.1186/s12958-016-0225-2.
2. Kavehmanesh Z, Amirsalari S, Torkaman M, Khalili
Matinzadeh Z, Haghiri M, Javadipour M. Frequency of
multiple pregnancy and its complications in three educational
hospitals, Tehran. Iran J Pediatr. 2007;17(2):261-7. [Persian].
3. Campbell-Yeo ML, Johnston CC, Joseph K, Feeley NL,
Chambers CT, Barrington KJ. Co-bedding as a comfort
measure for twins undergoing painful procedures (CComForT
Trial). BMC Pediatr. 2009;9:76. doi: 10.1186/1471-2431-9-
76.
4. Hayward K. Cobedding of twins: a natural extension of
the socialization process? MCN Am J Matern Child Nurs.
2003;28(4):260-3. doi: 10.1097/00005721-200307000-
00011.
5. Aftyka A, Rybojad B, Rosa W, Wróbel A, Karakuła-Juchnowicz
H. Risk factors for the development of post-traumatic stress
disorder and coping strategies in mothers and fathers following
infant hospitalisation in the neonatal intensive care unit. J Clin
Nurs. 2017;26(23-24):4436-45. doi: 10.1111/jocn.13773.
6. Jarvis M, Burnett M. Developmentally supportive care for
twins and higher-order multiples in the NICU: a review of
existing evidence. Neonatal Paediatr Child Health Nurs.
2009;12(3):2-5.
7. Johnston C, Campbell-Yeo M, Disher T, Benoit B, Fernandes
A, Streiner D, et al. Skin-to-skin care for procedural pain in
neonates. Cochrane Database Syst Rev. 2017;2(2):CD008435.
doi: 10.1002/14651858.CD008435.pub3.
8. Jahanfar S. Twins co-bedding at home, parents’ perspective,
sleeping pattern and developmental millstones. Shiraz E Med
J.2012;13(1):13-8. [Persian].
9. Badiee Z, Nassiri Z, Armanian A. Cobedding of twin premature
infants: calming effects on pain responses. Pediatr Neonatol.
2014;55(4):262-8. doi: 10.1016/j.pedneo.2013.11.008.
10. Chin SD, Hope L, Christos PJ. Randomized controlled
trial evaluating the effects of cobedding on weight gain
and physiologic regulation in preterm twins in the NICU.
Adv Neonatal Care. 2006;6(3):142-9. doi: 10.1016/j.
adnc.2006.02.008.
11. Sheehan N. Sisters Kept Close. Worcester, Massachusetts:
Worcester Sunday Telegram; 1995.
12. Campbell-Yeo ML, Johnston CC, Joseph KS, Feeley N,
Chambers CT, Barrington KJ. Cobedding and recovery time
after heel lance in preterm twins: results of a randomized
trial. Pediatrics. 2012;130(3):500-6. doi: 10.1542/peds.2012-
0010.
13. Nyqvist KH, Lutes LM. Co-bedding twins: a developmentally
supportive care strategy. J Obstet Gynecol Neonatal
Nurs. 1998;27(4):450-6. doi: 10.1111/j.1552-6909.1998.
tb02669.x.
14. Longobucco D, Bernstein B, Rossi D. To co-bed or not to cobed? A comparative study of co-bedded versus individually
bedded multiple birth infants in the NICU. Pediatr Res.
2000;47:413S.
15. LaMar K, Dowling DA. Incidence of infection for preterm
twins cared for in cobedding in the neonatal intensive-care
unit. J Obstet Gynecol Neonatal Nurs. 2006;35(2):193-8. doi:
10.1111/j.1552-6909.2006.00025.x.
16. Lutes LM, Altimier L. Co-bedding multiples. Newborn Infant
Nurs Rev. 2001;1(4):242-6. doi: 10.1053/ninr.2001.28104.
17. Byers JF, Yovaish W, Lowman LB, Francis JD. Co-bedding
versus single-bedding premature multiple-gestation infants in
incubators. J Obstet Gynecol Neonatal Nurs. 2003;32(3):340-
7. doi: 10.1177/0884217503253434.
18. Hayward K, Campbell-Yeo M, Price S, Morrison D, Whyte
R, Cake H, et al. Co-bedding twins: how pilot study findings
guided improvements in planning a larger multicenter
trial. Nurs Res. 2007;56(2):137-43. doi: 10.1097/01.
NNR.0000263967.24125.db.
19. Hack M, Schluchter M, Cartar L, Rahman M, Cuttler L,
Borawski E. Growth of very low birth weight infants to age
20 years. Pediatrics. 2003;112(1 Pt 1):e30-8. doi: 10.1542/
peds.112.1.e30.
20. Lai NM, Foong SC, Foong WC, Tan K. Co-bedding in neonatal
nursery for promoting growth and neurodevelopment
in stable preterm twins. Cochrane Database Syst Rev.
2016;4(4):CD008313. doi: 10.1002/14651858.CD008313.
pub3.
21. Orlando SM. The Effect of Co-Bedding Hospitalized Preterm
Multiple Birth Infants on Selected Physiological Variables
and Behavioral Cues [dissertation]. Louisiana State University
Health Sciences Center School of Nursing; 2007.
22. Boyd S. The way they were’: multiple gestation infants and
co-bedding. Journal of Neonatal Nursing-London. 2001;7:95.
23. Hayward KM, Johnston CC, Campbell-Yeo ML, Price SL,
Houk SL, Whyte RK, et al. Effect of cobedding twins on
coregulation, infant state, and twin safety. J Obstet Gynecol
Neonatal Nurs. 2015;44(2):193-202. doi: 10.1111/1552-
6909.12557.
Journal of Kerman University of Medical Sciences. Volume 29, Number 5, 2022 451
Co-bedding in the NICU for preterm twin care
24. Casey PH, Kraemer HC, Bernbaum J, Yogman MW, Sells JC.
Growth status and growth rates of a varied sample of low
birth weight, preterm infants: a longitudinal cohort from birth
to three years of age. J Pediatr. 1991;119(4):599-605. doi:
10.1016/s0022-3476(05)82414-x.
25. Cox S, Werner C, Hoffman B, Cunningham FG. Williams
Obstetrics 22nd Edition Study Guide. McGraw-Hill
Professional; 2005.
26. Polizzi J, Byers JF, Kiehl E. Co-bedding versus traditional
bedding of multiple-gestation infants in the NICU. J Healthc
Qual. 2003;25(1):5-10. doi: 10.1111/j.1945-1474.2003.
tb01025.x.
27. Niknafs P, Norouzi E, Bahman Bijari B, Baneshi MR. Can
we replace arterial blood gas analysis by pulse oximetry
in neonates with respiratory distress syndrome, who are
treated according to INSURE protocol? Iran J Med Sci.
2015;40(3):264-7.
28. Legrand A, Frondas A, Aubret F, Corre A, Flamant C, Simon
L, et al. Randomised controlled trial shows that co-bedding
twins may reduce birthweight recovery delay, parenteral
nutrition weaning time and hospitalisation. Acta Paediatr.
2017;106(12):2055-9. doi: 10.1111/apa.13885.
29. Kashaki M, Norouzi E, Heidarali S, Mohagheghi P, Soltani
M, Karbalaei Hasani H. Is there any correlation between
cerebrospinal fluid and serum C-reactive protein in
neonates suspected to meningitis? J Kerman Uni Med Sci.
2020;27(5):389-93. doi: 10.22062/jkmu.2020.91471.
)