Skin-to-skin contact to support preterm infants and reduce NICU-related stress.

OBJECTIVE: Hospitalization in the neonatal intensive care unit (NICU) with numerous painful medical interventions, being separated from parents, leads to the high risk of chronic stress for preterm infants. Today, many NICUs use more appropriate developmental care and pain management, but the early and long-term outcomes of stress in these vulnerable infants require searching for more stress-reducing interventions in neonatal care. The objective of the study was to investigate how skin-to-skin contact (SSC) can influence the biologic stress levels in preterm infants in the NICU by assessing cortisol and oxytocin levels. PARTICIPANTS AND METHODS: The study included 71 preterm infants with gestational age less than 34 + 0/7 weeks who were recruited from level III NICU. The overall design was a baseline-response design. Saliva and urine were collected before (baseline) and after skin-to-skin contact to measure salivary cortisol and urinary oxytocin by enzyme immunoassay method. RESULTS: The infants' baseline hormonal status was represented by the following indicators: the level of salivary cortisol was 0.402 [0.227; 1,271] µg/dl, urinary oxytocin 48.88 [32.97; 88.11] pg/ml. There was a decrease in salivary cortisol levels to 0.157 [0.088; 0.351] µg/dl compared to baseline (p Ë‚ 0.001) with a simultaneous increase of the urinary oxytocin level -73.59 [45.18; 108.8] pg/ml (p = 0.028) in response to SSC. CONCLUSION: Preterm infants in the NICU experience significant stress, characterized by hormonal imbalance: an increased level of the stress hormone cortisol and a decreased level of the anti-stress hormone oxytocin. Skin-to-skin contact helps to ameliorate the hormonal stress in preterm infants by activating the oxytocin release with simultaneous reduction of cortisol secretion.

Multisystem inflammatory syndrome in children (MIS-C) temporally associated with SARS-CoV-2: the first clinical case in Ternopil, Ukraine.

INTRODUCTION: Coronavirus disease (COVID-19) has led to a global pandemic among patients of all ages around the world. A new delayed inflammatory syndrome, with potentially severe evolution, has been described in the pediatric population, a population previously considered to be less vulnerable to the severe forms of COVID-19. CASE REPORT: We describe the first clinical case of multisystem inflammatory syndrome (MIS-C) in a 7-year-old child of the Ternopil region, Ukraine. Our clinical case fulfills the Royal College of Paediatrics and Child Health definition of MIS-C temporarily associated with COVID-19 -systemic disease with long-term fever, multiorgan dysfunction, laboratory evidence of hyperinflammation, positive SARS-CoV-2 tests, and the absence of an alternative cause that would explain the clinical picture. The patient was treated according to the treatment guidelines and subsequently was discharged with the resolution of his clinical symptoms. CONCLUSIONS: This clinical case draws the attention of general practitioners and pediatricians to the importance of timely diagnosis of a rare, but potentially severe multisystem inflammatory syndrome temporarily associated with COVID-19 in children.