# Stress Response of Preterm Infants to NICU Caregiving

> **NIH NIH F31** · OHIO STATE UNIVERSITY · 2024 · $27,847

## Abstract

PROJECT SUMMARY/ABSTRACT
Being born preterm is associated with long-term developmental delays that may not be apparent until well after
Neonatal Intensive Care Unit (NICU) hospitalization. Researchers have examined the potential effects of being
born preterm and neurodevelopmental outcomes and found that preterm infants have increased motor,
behavioral, and cognitive morbidities when compared to their term counterparts. These risks are increased for
Black/African American infants and male infants. Routine nursing care is a known, even though necessary,
stressor. However, mechanisms linking care to stress responses and sleep states in preterm infants is not fully
understood. The purpose of this study is to examine the effects of routine nursing care on stress and sleep
states in preterm infants. The specific aims are to: determine the relationship between routine nurse caregiving
and the post-caregiving stress response among preterm infants; and determine the relationship between
routine nurse caregiving on preterm infants’ post-caregiving behavior state. Secondary aims are to: examine
the relationships among stress and sleep states pre- and post-caregiving; explore the potential moderating
effect of history of stress exposure on effects of routine caregiving on stress response and behavior states
following care; and explore the potential moderating effect of pre-caregiving stress response and behavior
state on the relationship between routine caregiving and stress response and behavior state post-caregiving.
We will consider differences in biological sex and race in all analyses. We propose a non-experimental,
descriptive, observational study of 30 preterm infants born between 28-32 weeks gestational age. We will
observe one nurse caregiving event, recording stress exposures, stress responses, and behavior states.
Stress exposures will be measured using the Neonatal Infant Stressor Scale and data from the electronic
health record. Stress responses will be measured using salivary cortisol and skin conductance response.
Sleep behaviors will be measured using the Anderson Behavioral State Scale. The study findings will increase
our understanding of the effects of routine nurse caregiving on the stress response and sleep behaviors in
preterm infants in the NICU. These findings can lead to improved caregiving practices, thus, improving
neurodevelopmental outcomes. This study aligns with the National Institute of Nursing Research’s strategic
plan for prevention and health promotion by addressing a clinical model of care. The research is an important
step in the development of targeted interventions to optimize neurodevelopmental outcomes for preterm
infants. The training plan will provide numerous formal and informal opportunities for professional development
while allowing building a solid foundation for a successful career as an independent researcher. This study
builds on the applicant’s experiences as a NICU nurse and research assistant and integra...

## Key facts

- **NIH application ID:** 10840295
- **Project number:** 5F31NR020849-02
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Nicole Cistone
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $27,847
- **Award type:** 5
- **Project period:** 2023-05-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10840295

## Citation

> US National Institutes of Health, RePORTER application 10840295, Stress Response of Preterm Infants to NICU Caregiving (5F31NR020849-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10840295. Licensed CC0.

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