Comparison of the Effects of Supine and Prone Positions on Oxygen Saturation and Vital Signs in Premature Infants: A Crossover Clinical Trial

Document Type : Original Article

Authors

1 Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran

2 Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran

3 Department of Biostatistics, School of Medicine, Arak University of Medical Sciences, Arak, Iran

Abstract

Background: Positioning of premature newborns significantly affects their health status. However, the most suitable position remains controversial. The current study aimed to compare the effect of supine and prone positions on oxygen saturation and vital signs in premature newborns.
Methods: In this crossover clinical trial, a total of 22 newborns admitted to the Neonatal Intensive Care Unit (NICU) of Amir Kabir Hospital in Arak, Iran, were selected through purposive sampling technique, and then randomly assigned into groups 1 and 2. Newborns in group 1 were first placed in a prone position (i.e., the first period for 3 h), and then in a supine position (i.e., the second period for an additional 3 h). The reverse procedure was applied to the intervention group 2. Heart rate, respiratory rate, and oxygen saturation were measured and recorded every 15 min.
Results: The mean oxygen saturation in the prone position (96.164±0.148) was higher than in the supine position (90.479±0.513; P=0.0001). The mean heart rate in the prone position (138.24±1.87 beats/min) was lower than that in the supine position (147.48±1.597 beats/min; P=0.0001). The mean respiratory rate in the prone position (40.430±0.504 breaths/min) was lower than that in the supine position (46.773±0.685 breaths/min; P=0.0001).
Conclusion: The current study demonstrated that the prone position put the newborn admitted to NICU in a more stable condition. However, the selection of the best position must be made based on the newborn’s health status and situation.

Keywords


1. Word Health Organization. Media Centre. Preterm birth. Fact sheet. Geneva: Word Health Organization; 2017.
2. Howson CP, Kinney MV, McDougall L, Lawn JE. Born too soon: preterm birth matters. Reprod Health. 2013; 10(1):S1.
3. Sharifi N, Khazaeian S, Pakzad R, Fathnezhad Kazemi A, Chehreh H. Investigating the prevalence of preterm birth in Iranian population: a systematic review and meta-analysis. J Caring Sci. 2017; 6(4):371-80.
4. Picheansathian W, Woragidpoonpol P, Baosoung C. Positioning of preterm infants for optimal physiological development: a systematic review. JBI Database Syst Rev Implementat Rep. 2009; 7(7):224-59.
5. Torabi Z, Ghaheri V, Falak Aflaki B. The effect of body position on the arterial oxygen saturation of healthy premature neonate: a clinical trial. J Mazandaran Univ Med Sci. 2012; 22(86):234-42. (Persian)
 6. Candia MF, Osaku EF, Leite MA, Toccolini B, Costa NL, Teixeira SN, et al. Influencia do posicionamentoempronasobre o estresse no recem-nascidoprematuroavaliada pela dosage de cortisol salivar: um estudopiloto. Rev Bras Ter Intensiva. 2014; 26(2):169-75.
 7. Ma M, Noori S, Maarek JM, Holschneider DP, Rubinstein EH, Seri I. Prone positioning decreases cardiac output and increases systemic vascular resistance in neonates. J Perinatol. 2015; 35(6): 424-7.
8. Blair PS, Platt MW, Smith IJ, Fleming PJ. Sudden neonate death syndrome and sleeping position in pre-term and low birth weight neonates: an opportunity for targeted intervention. Arch Dis Child. 2006; 91(2):101-6.
 9. Poets CF, von Bodman A. Placing preterm neonates