Background <p>Very preterm (VP) infants undergo rapid brain development while hospitalized in the neonatal intensive care unit (NICU). Meaningful auditory experiences enhance brain development, yet understanding VP infants’ auditory environment remains a challenge. We examined the trajectories of auditory exposures of VP infants before term-equivalent age.</p> Methods <p>This was a prospective, observational study of 25 VP infants born ≤32 weeks and 6 days gestation in a hybrid-design NICU. We collected 128 auditory recordings using language environment analysis (LENA) devices, with up to six consecutive weekly recordings per infant. We performed repeated-measure correlations between auditory measurements and postmenstrual age (PMA) and assessed relationships with room type and parental presence using stratification.</p> Results <p>Between 31 and 39 weeks PMA, VP infants experienced primarily silence (63.2% of recorded time) and electronic sounds (14.5%), with overall limited meaningful language exposure (3.9%). With advancing PMA and transitioning from single-family rooms to semi-private bays, meaningful language increased (<i>r</i> = 0.54, <i>p</i> &lt; 0.001) and noise exposure decreased (<i>r</i> = −0.59, <i>p</i> &lt; 0.001). Higher parental presence appeared to positively correlate with language exposure.</p> Conclusion <p>VP infants experience reduced meaningful auditory exposures during NICU hospitalization. Further work should examine how modifiable NICU environment factors could be leveraged to optimize auditory experiences during a sensitive period.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>NICU auditory environments remain suboptimal for preterm infants, with a predominance of silence and limited meaningful experiences.</p> </ItemContent> <ItemContent> <p>In this hybrid-design NICU, meaningful language exposures monitored longitudinally increased with advancing postmenstrual age and as infants transitioned from single-family rooms to semi-private bays.</p> </ItemContent> <ItemContent> <p>Modifiable factors, including NICU designs, models of care, and parental presence, may play a role in optimizing auditory exposures of preterm infants.</p> </ItemContent> <ItemContent> <p>A better understanding of factors influencing the auditory experience can facilitate the design of effective interventions in the NICU.</p> </ItemContent> </UnorderedList></p>

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Evolution of the auditory environment of very preterm infants before term-equivalent age in relation to room type and parental presence

  • Gabriel Côté-Corriveau,
  • Sara Cherkerzian,
  • Terrie Inder,
  • Carmina Erdei

摘要

Background

Very preterm (VP) infants undergo rapid brain development while hospitalized in the neonatal intensive care unit (NICU). Meaningful auditory experiences enhance brain development, yet understanding VP infants’ auditory environment remains a challenge. We examined the trajectories of auditory exposures of VP infants before term-equivalent age.

Methods

This was a prospective, observational study of 25 VP infants born ≤32 weeks and 6 days gestation in a hybrid-design NICU. We collected 128 auditory recordings using language environment analysis (LENA) devices, with up to six consecutive weekly recordings per infant. We performed repeated-measure correlations between auditory measurements and postmenstrual age (PMA) and assessed relationships with room type and parental presence using stratification.

Results

Between 31 and 39 weeks PMA, VP infants experienced primarily silence (63.2% of recorded time) and electronic sounds (14.5%), with overall limited meaningful language exposure (3.9%). With advancing PMA and transitioning from single-family rooms to semi-private bays, meaningful language increased (r = 0.54, p < 0.001) and noise exposure decreased (r = −0.59, p < 0.001). Higher parental presence appeared to positively correlate with language exposure.

Conclusion

VP infants experience reduced meaningful auditory exposures during NICU hospitalization. Further work should examine how modifiable NICU environment factors could be leveraged to optimize auditory experiences during a sensitive period.

Impact

NICU auditory environments remain suboptimal for preterm infants, with a predominance of silence and limited meaningful experiences.

In this hybrid-design NICU, meaningful language exposures monitored longitudinally increased with advancing postmenstrual age and as infants transitioned from single-family rooms to semi-private bays.

Modifiable factors, including NICU designs, models of care, and parental presence, may play a role in optimizing auditory exposures of preterm infants.

A better understanding of factors influencing the auditory experience can facilitate the design of effective interventions in the NICU.