Premature newborn positionings and physiologic parameters – a randomized clinical study

Abstract

Introduction: Multiple studies have shown the effects of prone (PP), supine (SP) and kangaroo (KP) positions on clinical and physiological outcomes in preterm newborns, but none compared these three types of positioning between them. Objective: To investigate the influence of these positionings on heart rate, respiratory rate, peripheral oxygen saturation (SpO₂) and alertness status in clinically stable preterm newborns (NBs) admitted to a neonatal intensive care unit. Methods: In a randomized clinical trial, clinically stable NBs with gestational ages from 30 to 37 weeks who were breathing spontaneously were allocated in three positioning groups: PP, SP and KP. SpO₂, heart rate, breathing frequency and alertness status were evaluated immediately before and after 30 minutes of positioning. Results: In all, 66 NBs were assessed (corrected age: 35.48 ± 1.94 weeks; weight: 1840.14 ± 361.09 g), (PP: n = 22; SP: n = 23; KP: n = 21). NBs in the PP group showed a significant improvement in peripheral SpO₂ (97.18 ± 2.16 vs 95.47 ± 2.93 vs 95.57 ± 2.95, p = 0.03) compared with the SP and KP groups. Conclusion: In clinically stable preterm NBs, the PP was associated with better peripheral oxygen saturation than the SP or KP. In addition, there was a reduction in heart rate within prone position group and in the KP group there was an increase in the number of NBs in the deep sleep classification.