17 November - World Prematurity Day.

Premature birth, before the 37th week of gestation, is a common condition affecting 1/10 newborns, with a worldwide estimate of around 15 million births per year.
Complications of this prematurity condition are estimated to cause 35% of global neonatal deaths and are considered the second leading cause of death in children under 5 years of age, just after pneumonia.

During the first year of life, a premature baby exhibits poorer health status in association with neurodevelopment and cognitive delays than a non-premature newborn.
To protect this fragile life, different monitoring methods are adopted in neonatal intensive care, such as the assessment of partial oxygen saturation and heart rate (HR).

These assessments are among the most appropriate to determine the biological response to stress. The postnatal HR in spontaneously breathing full-term infants is over 100 bpm; in the premature, the HR is relevant and extinguishes a threat if it shows a change from the expected levels.

HR abnormalities can occur and cause functional problems in the autonomic nervous system. The heartbeat is influenced by sympathetic (norepinephrine) and parasympathetic (acetylcholine) activity, which leads to frequent small accelerations and decelerations, respectively. Stress and potentially painful stimuli increase sympathetic activity, generating an increase in heart rate.

Partial oxygen saturation is fundamental in the clinical care of premature babies. Low partial oxygen saturation values may correlate with reduced survival, while high oxygen saturation rates may have detrimental effects and are associated with premature retinopathy a pathology of high incidence that affects premature babies

Therefore, special care and attention should be given to stress management and its fundamental role in the care of the premature baby, concerning his/her growth and neuropsychological development. Several studies have found in the premature baby a decrease in stress levels associated with a specific form of touch.

It has been observed that this form of manual contact has direct effects on the baby's autonomic nervous system: reducing the levels of cortisol produced by stress response mediated by the activity of the sympathetic nervous system, potentially improving the adaptability and health of the premature baby. Soft-touch has well defined neurophysiological characteristics: it is a tactile stimulus of gentle, slow and moderate pressure, capable of stimulating a type of fibres, the C-tactile fibres which are present in the skin. These fibres are part of the "interoceptive system", which collects and informs the brain about the signals from outside, called afferents, throughout the body and integrates them in an area of the brain called the insular cortex, to elaborate the best possible response to environmental stress, thus activating the baby's immune system.

In the case of premature babies, osteopathic treatment produces a reduction in HR as well as an increase in partial oxygen saturation in premature babies. These results suggest that osteopathic intervention may induce beneficial effects on the physiological parameters of the preterm infant. This opens new insights for the optimization of modern approaches in perinatal care.

Elsevier Scientific Publication - Effects of osteopathic treatment versus static touch on heart rate and oxygen saturation in premature babies: A randomized controlled trial

Specialist in Exercise and Health
Osteopath
(Professional Licence: C-003 1060)