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Monday, November 2, 2009: 2:20 PM
Neonatal Nutritive Sucking Organization After Maternal Epidural Analgesia
Problem: Use of epidural during labor continues to rise in the U. S. without clear understanding of effects on neonatal neurobehavioral organization, due to controversial and conflicting findings.
Purpose: To explore whether infants exposed to maternal epidural, compared to infants exposed to unmedicated labor, would exhibit attenuated nutritive sucking organization (an indirect measure of neonatal neurobehavioral organization) at the initial feeding one hour after birth.
Methods: A comparative design, explored relationships between unmedicated labor, epidural analgesia, and a quantitative measure of nutritive sucking organization one hour after birth in 52 mother-infant dyads (17 unmedicated, 34 epidural). A Nutritive Sucking Apparatus (a tailored engineered instrument) measured sucking organization at the initial feeding. Data was acquired using the Biopac/AcqKnowledge system. Data was detected and summarized by a tailored suck detection software program. Due to the study’s explorative nature, p < .10 determined significance.
Results: An interaction between gender and drug dosage was evident. Girls exposed to unmedicated labor exhibited significantly greater number of sucks than girls exposed to maternal epidural, or high dosages of either bupivicaine or fentanyl. There were no differences in girl’s number of sucks between low dosages of either drug and the unmedicated or high dosage groups. Boys did not exhibit significant relationships between epidural exposure (or dosage) and number of sucks. Exposure to epidural was not significantly related to sucking pressure; although, girls exhibited significantly stronger sucking pressures than boys, and Latino boys exhibited significantly weaker sucking pressures than Latina girls or Black boys.
Implications: Effect sizes were generated for nutritive sucking parameters at the initial feeding after birth. Girls appeared more organized than boys, and influenced by exposure to high dosages of epidural. Gender and race/ethnicity should be included in research on neonatal nutritive sucking organization.
Problem: Use of epidural during labor continues to rise in the U. S. without clear understanding of effects on neonatal neurobehavioral organization, due to controversial and conflicting findings.
Purpose: To explore whether infants exposed to maternal epidural, compared to infants exposed to unmedicated labor, would exhibit attenuated nutritive sucking organization (an indirect measure of neonatal neurobehavioral organization) at the initial feeding one hour after birth.
Methods: A comparative design, explored relationships between unmedicated labor, epidural analgesia, and a quantitative measure of nutritive sucking organization one hour after birth in 52 mother-infant dyads (17 unmedicated, 34 epidural). A Nutritive Sucking Apparatus (a tailored engineered instrument) measured sucking organization at the initial feeding. Data was acquired using the Biopac/AcqKnowledge system. Data was detected and summarized by a tailored suck detection software program. Due to the study’s explorative nature, p < .10 determined significance.
Results: An interaction between gender and drug dosage was evident. Girls exposed to unmedicated labor exhibited significantly greater number of sucks than girls exposed to maternal epidural, or high dosages of either bupivicaine or fentanyl. There were no differences in girl’s number of sucks between low dosages of either drug and the unmedicated or high dosage groups. Boys did not exhibit significant relationships between epidural exposure (or dosage) and number of sucks. Exposure to epidural was not significantly related to sucking pressure; although, girls exhibited significantly stronger sucking pressures than boys, and Latino boys exhibited significantly weaker sucking pressures than Latina girls or Black boys.
Implications: Effect sizes were generated for nutritive sucking parameters at the initial feeding after birth. Girls appeared more organized than boys, and influenced by exposure to high dosages of epidural. Gender and race/ethnicity should be included in research on neonatal nutritive sucking organization.