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American Academy of Pediatrics
Article

Cobedding and Recovery Time After Heel Lance in Preterm Twins: Results of a Randomized Trial

Marsha L. Campbell-Yeo, C. Celeste Johnston, K.S. Joseph, Nancy Feeley, Christine T. Chambers and Keith J. Barrington
Pediatrics September 2012, 130 (3) 500-506; DOI: https://doi.org/10.1542/peds.2012-0010
Marsha L. Campbell-Yeo
aWomen’s and Newborn Health Program, and
bMcGill University, Montreal, Quebec, Canada;
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C. Celeste Johnston
aWomen’s and Newborn Health Program, and
bMcGill University, Montreal, Quebec, Canada;
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K.S. Joseph
cDepartment of Obstetrics and Gynaecology and the School of Population and Public Health, University of British Columbia and the Children’s and Women’s Hospital of British Columbia, Vancouver, British Columbia, Canada;
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Nancy Feeley
bMcGill University, Montreal, Quebec, Canada;
dCentre for Nursing Research, Jewish General Hospital and The Quebec Interuniversity Nursing Intervention Research Group, Montreal, Quebec, Canada; and
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Christine T. Chambers
eCentre for Pediatric Pain Research and the Departments of Pediatrics and Psychology, IWK Health Centre, Halifax, Nova Scotia, Canada;
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Keith J. Barrington
fDivision of Neonatology, Sainte-Justine University Hospital and Université du Montréal, Montréal, Quebec
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Abstract

OBJECTIVES: Cobedding of preterm twin infants provides tactile, olfactory, and auditory stimulation and may affect pain reactivity. We carried out a randomized trial to assess the effect of cobedding on pain reactivity and recovery in preterm twin neonates.

METHODS: Stable preterm twins (n = 67 sets) between 28 and 36 weeks of gestational age were randomly assigned to a cobedding group (cared for in the same incubator or crib) or a standard care group (cared for in separate incubators or cribs). Pain response (determined by the Premature Infant Pain Profile [PIPP]) and time to return to physiologic baseline parameters were compared between groups with adjustment for the nonindependence of twin infants.

RESULTS: Maternal and infant characteristics were not significantly different between twin infants in the cobedding and standard care groups except for 5-minute Apgar <7 and postnatal age and corrected gestational age on the day of the heel lance. Mean PIPP scores were not different between groups at 30, 60, or 120 seconds. At 90 seconds, mean PIPP scores were higher in the cobedding group (6.0 vs 5.0, P = .04). Recovery time was shorter in the cobedding group compared with the standard care group, (mean = 75.6 seconds versus 142.1 seconds, P = .001). No significant adverse events were associated with cobedding. Adjustment for nonindependence between twins and differences in baseline characteristics did not change the results.

CONCLUSIONS: Cobedding enhanced the physiologic recovery of preterm twins undergoing heel lance, but did not lead to lower pain scores.

KEY WORDS
  • cobedding
  • twin
  • pain
  • preterm
  • infant
  • physiologic stability
  • recovery
  • Abbreviations:
    GEE —
    generalized estimating equation
    PIPP —
    Premature Infant Pain Profile
    • Accepted April 30, 2012.
    • Copyright © 2012 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 130, Issue 3
    1 Sep 2012
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    Cobedding and Recovery Time After Heel Lance in Preterm Twins: Results of a Randomized Trial
    Marsha L. Campbell-Yeo, C. Celeste Johnston, K.S. Joseph, Nancy Feeley, Christine T. Chambers, Keith J. Barrington
    Pediatrics Sep 2012, 130 (3) 500-506; DOI: 10.1542/peds.2012-0010

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    Cobedding and Recovery Time After Heel Lance in Preterm Twins: Results of a Randomized Trial
    Marsha L. Campbell-Yeo, C. Celeste Johnston, K.S. Joseph, Nancy Feeley, Christine T. Chambers, Keith J. Barrington
    Pediatrics Sep 2012, 130 (3) 500-506; DOI: 10.1542/peds.2012-0010
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