A systematic review of chronobiology for neonatal care units: What we know and what we should consider

Philip Lewis, Ursula Wild, J. Jane Pillow, Russell G. Foster, Thomas C. Erren

Research output: Contribution to journalReview articlepeer-review

1 Citation (Web of Science)

Abstract

A Cochrane 2016 review indicated cycled light might benefit neonatal health in hospital. We systematically reviewed chronobiological factors for neonatal health in hospital units, identifying 56 relevant studies on light-dark cycles, feeding, noise, massage therapy, rooming-in, incubators vs. cribs, neonatal units vs. homes, and time-of-day of birth. Empirical evidence for benefits from chronobiology is weaker than expected, including light. Mechanisms of clinical benefits are unclear (e.g., changes to sleep/activity vs. other circadian-regulated processes). Regarding light, studies concerning sleep and circadian-related outcomes predominate; yet, neo-natologists may be more interested in weight gain and time spent in hospital. Generalisability of findings is limited as most studies targeted neonates in stable condition and without congenital anomalies. Further research is needed, in particular concerning potential circadian entraining signals such as timing of meals or medications. Longer-term outcomes (regarding e.g., neurodevelopment and infection), and who may be at risk from time-of-day of birth effects and why remain to be explored. Overall, there is promise and ample scope for research into how chronobiological factors affect health in hospitalised neonates.
Original languageEnglish
Article number101872
Number of pages14
JournalSleep Medicine Reviews
Volume73
Early online date23 Nov 2023
DOIs
Publication statusPublished - Feb 2024

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