Effect of Massage on Salivary Cortisol Level in Preterm Neonates

Document Type: Original Article


Department of Child Health, Faculty of Medicine, Airlangga University, Dr.Soetomo Hospital, Surabaya, Indonesia


Background: Stress in preterm neonates is associated with morbidity and mortality. Preterm newborns who are in need of special care are at risk of experiencing stress because of separation from the mother, ambient noises, lighting intensity, and medical procedures. Massage is believed to reduce stress through touch stimulation, and the cortisol is one of the indicators of the stress response. This study aimed to identify the effects of touch stimulation in the form of massage on salivary cortisol in preterm neonates.
Methods: This study was conducted based on a quasi-experimental design. The neonates were divided into intervention and control groups who received massage and standard therapy (n=19) and only the standard therapy (n=20), respectively. The massage was given to the infants three times daily for 15 min. Salivary cortisol was measured after 10 days of intervention.
Results: According to the results, the mean salivary cortisol concentration of the control group was higher (0.53±0.73 μg/dL) than that in the intervention group (0.05±0.32 μg/dL). Moreover, there was a significant difference between the groups regarding the salivary cortisol level at pre- and post-test (P=0.001). Based on the pre-test and post-test results, there was a significant decrease in salivary cortisol levels in the intervention group, compared to the control group (P=0.03 versus P=0.53). It should be noted that there were no observable side effects during the intervention.
Conclusion: Based on a decrease in salivary cortisol levels, this study suggests that touch stimulation given as a massage may reduce the level of stress in preterm neonates.


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