The Effect of Incubator Cover on Newborn Vital Signs: The Design of Repeated Measurements in Two Separate Groups with No Control Group

Abstract

(1) Background: During their stays in neonatal intensive care units (NICU), newborns are exposed to many stimuli that disrupt their physiological indicators. The aim of this study was to investigate the impact of the light-dark cycle created with and without an incubator cover on the vital signs of term and preterm newborns. (2) Methods: A repeated measures design was used in the study utilizing two separate groups, without a control group. The study included 91 neonates hospitalized in a NICU (44 term and 47 preterm). With and without an incubator cover, the newborns' vital signs (heart rate (HR), respiratory rate (RR), oxygen saturation (SpO₂), and body temperature (BT)) were measured. Three separate measurements were taken. (3) Results: The mean age of the newborns was 37.0 weeks. There was no significant difference between the HR and RR medians of the term and preterms in the incubator undraped and clad measurements (p > 0.05). At the first measurement, the SpO₂ medians of the incubator-covered term and preterms were significantly higher than those of the incubator-covered term and preterms (p = 0.001). (4) Conclusions: The vital signs of the neonates demonstrated variable responses in the measurements when their incubators were covered vs. when they were not covered. However, more research on the effect of the light-dark cycle on their vital signs is required.

Keywords: incubator cover; light-dark cycle; preterm; term; vital signs.

Figure 1

Cover for incubators designed by researchers.

Figure 2

Graphical abstract of this study.

Figure 3

CONSORT diagram of this study.

Figure 4

Comparison of median heart rate of newborns with and without incubator cover. ^a Heart rate at 1st min, Abbreviations: min = Minute. Notes: The median pulse rates at 0 min, 15 min, and 30 min are provided. In repeated measurements, the first measurement was taken at the 0th min, the second at the 15th min, and the third at the 30th min. The Friedman (χ²) test was used to examine the variation in repeated pulse rate measurements.

Figure 5

Comparison of median respiratory rate of newborns with and without incubator cover. ^a Respiratory rate at 1st min, Abbreviations: min = Minute. Notes: The median respiratory rates at 0 min, 15 min, and 30 min are provided. In repeated measurements, the first measurement was taken at the 0th min, the second at the 15th min, and the third at the 30th min. The Friedman (χ²) test was used to examine the variation in repeated respiratory rate measurements.

Figure 6

Comparison of medians of oxygen saturation of newborns with and without incubator cover. ^a Oxygen saturation at 1st min, Abbreviations: min = Minute. Notes: The median oxygen saturation at 0 min, 15 min, and 30 min are provided. In repeated measurements, the first measurement was taken at the 0th min, the second at the 15th min, and the third at the 30th min. The Friedman (χ²) test was used to examine the variation in repeated oxygen saturation measurements.

Figure 7

Comparison of median body temperature of newborns with and without incubator cover. ^a Body temperature at 1st min, Abbreviations: min = Minute. Notes: The median body temperature at 0 min, 15 min, and 30 min are provided. In repeated measurements, the first measurement was taken at the 0th min, the second at the 15th min, and the third at the 30th min. The Friedman (χ²) test was used to examine the variation in repeated body temperature measurements.