Osteopathic Manipulative Treatment in Neonatal Intensive Care Units
Abstract
:1. Introduction
2. Materials and Methods
- baseline information, i.e., personal and socio-demographic information of the baby and the parents, diagnosis at admittance (disease classification based on ICD9-CM standard code), delivery type, and clinical data of the baby at birth (e.g., weight, length, cranial circumference, milk intake);
- follow-up information, i.e., weight, length of stay, spontaneous stool, regurgitation, bilious stasis, blood stasis, gastric vomiting.
2.1. Osteopathic Intervention
2.2. Statistical Methods
3. Results
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Overall | Overall Cohort | Preterm Babies | ||||||
---|---|---|---|---|---|---|---|---|
Variable | Category | Treated (OMT) | Non Treated | p-Value | Treated (OMT) | Non Treated | p-Value | |
N. Group | 1249 | 597 | 652 | 296 | 315 | |||
Gestational age (weeks) | 36.1 ± 3.5 | 36.2 ± 3.4 | 36.0 ± 3.6 | 0.78 | 33.3 ± 2.3 | 32.9 ± 2.6 | 0.09 | |
Cranial circumference (cm) | 299.6 ± 82.7 | 308.1 ± 71.5 | 291.5 ± 91.3 | 0.03 | 282.5 ± 79.5 | 268.7 ± 91.4 | 0.04 | |
Length (cm) | 431.5 ± 120.0 | 445.4 ± 100.8 | 418.5 ± 134.3 | 0.008 | 404.6 ± 110.8 | 384.1 ± 130.6 | 0.04 | |
Weight (g) | 2576.6 ± 859.5 | 2598.2 ± 852.0 | 2556.6 ± 866.6 | 0.53 | 1996.1 ± 603.5 | 1923.4 ± 643.0 | 0.17 | |
Gender | Female | 571 (45.7) | 271 (45.4) | 300 (46.0) | 0.83 | 133 (44.9) | 149 (47.3) | 0.56 |
Male | 678 (54.3) | 326 (54.6) | 352 (54.0) | 163 (55.1) | 166 (52.7) | |||
Type of delivery | Spontaneous | 460 (36.8) | 218 (36.5) | 242 (37.1) | 0.98 | 70 (23.6) | 76 (24.1) | 0.80 |
Emergency cesarean section | 271 (21.7) | 130 (21.8) | 141 (21.6) | 31 (10.5) | 28 (8.9) | |||
Elective cesarean section | 518 (41.5) | 249 (41.7) | 269 (41.3) | 195 (65.9) | 211 (67.0) | |||
Diagnosis (ICD9-CM) | Twin pregnancy, both born alive | 59 (4.7) | 36 (6.0) | 23 (3.5) | 0.05 | 33 (11) | 18 (5.7) | 0.02 |
Unspecified prematurity, immaturity, low birth weight | 509 (41) | 240 (40) | 269 (41) | 0.77 | 230 (78) | 252 (80) | 0.75 | |
Neonatal respiratory distress syndrome | 286 (23) | 122 (20) | 164 (25) | 0.08 | 88 (30) | 111 (35) | 0.23 | |
Transient tachypnea of newborn | 62 (5.0) | 35 (5.9) | 27 (4.1) | 0.17 | 6 (2.0) | 4 (1.3) | 0.47 | |
Unspecified perinatal jaundice | 223 (18) | 104 (17) | 119 (18) | 0.73 | 70 (24) | 81 (26) | 0.61 | |
Anemia | 98 (7.8) | 45 (7.5) | 53 (8.1) | 0.71 | 41 (14) | 48 (15) | 0.65 | |
Neonatal hypoglycemia | 53 (4.2) | 24 (4.0) | 29 (4.4) | 0.71 | 9 (3.0) | 11 (3.5) | 0.76 | |
Neonatal hypocalcemia and hypomagnesemia | 44 (3.5) | 22 (3.7) | 22 (3.4) | 0.77 | 8 (2.7) | 6 (1.9) | 0.52 | |
Septicemia | 40 (3.2) | 20 (3.4) | 20 (3.1) | 0.78 | 4 (1.4) | 7 (2.2) | 0.43 | |
Fever | 36 (2.9) | 17 (2.8) | 19 (2.9) | 0.95 | 5 (1.6) | 4 (1.4) | 0.81 | |
Milk intake at admission (cc) | 143.0 ± 152.5 | 144.3 ± 151.5 | 141.8 ± 153.6 | 0.34 | 86.5 ± 108.8 | 82.9 ± 90.2 | 0.27 |
Population | Treatment | N | Mean Estimate (95% CI) * | Mean Estimated Difference (95% CI) * | p-Value * | Mean Estimate (95% CI) † | Mean Estimated Difference (95% CI) † | p-Value † |
---|---|---|---|---|---|---|---|---|
Overall | OMT | 584 | 26.0 (18.1; 33.9) | −7.9 (−18.5; 2.7) | 0.15 | 25.8 (18.2; 33.5) | −5.2 (−15.6; 5.1) | 0.32 |
Control | 506 | 33.9 (26.8; 40.9) | − | - | 31.1 (24.2; 37.9) | - | - | |
Preterm babies | OMT | 243 | 26.4 (17.4; 35.4) | −12.3 (−24.0; −0.5) | 0.04 | 29.2 (22.3; 36.0) | −2.1 (−11.2; 7.1) | 0.65 |
Control | 282 | 38.7 (31.0; 46.3) | - | 31.3 (25.4; 37.1) | - | |||
GA 27–31 weeks | OMT | 53 | 37.0 (7.3; 66.8) | −39.4 (−74.0; −4.8) | 0.005 | 27.5 (7.9; 47.0) | −33.8 (−55.6; −12.0) | 0.002 |
Control | 77 | 76.4 (58.8; 94.1) | - | - | 61.3 (48.2; 74.4) | - | - | |
GA 32–33 weeks | OMT | 60 | 35.1 (20.1; 50.0) | 9.1 (−11.5; 29.7) | 0.46 | 27.5 (7.9; 47.0) | 10.3 (−8.5; 29.1) | 0.29 |
Control | 54 | 26.0 (11.7; 40.2) | - | - | 24.7 (11.4; 38.0) | - | - | |
GA 34–36 weeks | OMT | 130 | 20.8 (10.5; 31.1) | −3.1 (−17.1; 10.9) | 0.67 | 20.1 (11.8; 28.4) | 4.7 (−6.8; 16.2) | 0.42 |
Control | 151 | 23.9 (14.4; 33.4) | - | - | 24.8 (15.9; 33.8) | - | - |
Group | Overall Number of Episodes | % of Patients with at Least 1 Episode | Distribution of Episode (Median and Range) | IR per Person-Year (95% CI) | IRR (95% CI) | |
---|---|---|---|---|---|---|
(A) Overall sample (N = 1249) | ||||||
Spontaneous stool | OMT | 4411 | 98 | 7.0 (0.0–54.0) | 262.0 (243.1; 282.3) | 1.14 (1.03; 1.27) |
Control | 5129 | 97 | 6.0 (0.0–71.0) | 229.3 (213.8; 245.8) | ||
Regurgitation | OMT | 95 | 12 | 0.0 (0.0–5.0) | 5.82 (4.7; 7.2) | 0.96 (0.72; 1.29) |
Control | 145 | 15 | 0.0 (0.0–8.0) | 6.0 (5.0; 7.3) | ||
Bilious stasis | OMT | 135 | 4.2 | 0.0 (0.0–86.0) | 8.9 (7.1; 11.2) | 1.91 (1.34; 2.73) |
Control | 92 | 5.3 | 0.0 (0.0–11.0) | 4.6 (3.5; 6.1) | ||
Blood stasis | OMT | 18 | 2.2 | 0.0 (0.0–5.0) | 1.2 (0.9; 1.7) | 0.57 (0.39; 0.85) |
Control | 41 | 3.8 | 0.0 (0.0–6.0) | 2.1 (1.7; 2.6) | ||
Gastric vomiting | OMT | 167 | 21 | 0.0 (0.0–9.0) | 9.2 (7.5; 11.3) | 0.88 (0.68; 1.15) |
Control | 226 | 23 | 0.0 (0.0–10.0) | 10.5 (8.9; 12.4) | ||
(B) Preterm babies (N = 611) | ||||||
Spontaneous stool | OMT | 2565 | 99 | 8.0 (0–49.0) | 223 (202–246) | 1.08 (0.95–1.23) |
Control | 3422 | 98 | 9.0 (0–71.0) | 205 (189–223) | ||
Regurgitation | OMT | 57 | 14 | 0 (0–5.0) | 5 (4–7) | 1.02 (0.71–1.47) |
Control | 87 | 18 | 0 (0–8.0) | 5 (4–6) | ||
Bilious stasis | OMT | 121 | 6.2 | 0 (0–86.0) | 11 (8–15) | 2.31 (1.47–3.64) |
Control | 77 | 8.5 | 0 (0.11.0) | 5 (3–7) | ||
Blood stasis | OMT | 3 | 1.2 | 0 (0–1) | 0.3 (0.1–0.6) | 0.14 (0.07–0.30) |
Control | 31 | 5 | 0 (0–6) | 1.9 (1.5–2.4) | ||
Gastric vomiting | OMT | 102 | 26 | 0 (0–9) | 9 (7–11) | 1.14 (0.82–1.58) |
Control | 128 | 29 | 0 (0–10) | 8 (6–10) |
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Cicchitti, L.; Di Lelio, A.; Barlafante, G.; Cozzolino, V.; Di Valerio, S.; Fusilli, P.; Lucisano, G.; Renzetti, C.; Verzella, M.; Rossi, M.C. Osteopathic Manipulative Treatment in Neonatal Intensive Care Units. Med. Sci. 2020, 8, 24. https://doi.org/10.3390/medsci8020024
Cicchitti L, Di Lelio A, Barlafante G, Cozzolino V, Di Valerio S, Fusilli P, Lucisano G, Renzetti C, Verzella M, Rossi MC. Osteopathic Manipulative Treatment in Neonatal Intensive Care Units. Medical Sciences. 2020; 8(2):24. https://doi.org/10.3390/medsci8020024
Chicago/Turabian StyleCicchitti, Luca, Alessandra Di Lelio, Gina Barlafante, Vincenzo Cozzolino, Susanna Di Valerio, Paola Fusilli, Giuseppe Lucisano, Cinzia Renzetti, Marco Verzella, and Maria Chiara Rossi. 2020. "Osteopathic Manipulative Treatment in Neonatal Intensive Care Units" Medical Sciences 8, no. 2: 24. https://doi.org/10.3390/medsci8020024