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Physiological and behavioral stability of newborns on therapeutic hypothermia for hypoxic-ischemic encephalopathy during parental holding

Pediatric Research (2025)Cite this article

A Comment to this article was published on 17 June 2025

Abstract

Background

Physical separation contributes to parental trauma and poor bonding in the context of therapeutic hypothermia (TH) for hypoxic-ischemic encephalopathy (HIE). Parental holding (PH) may improve parents’ experience. We aim to determine the physiological and behavioral stability of the newborn held by the parents during TH.

Methods

Observational, prospective, single-center study which included 30 newborns with mean gestational age of 39 (1.8) weeks and mean birth weight 3165 (508) g, with HIE treated by TH, whom parents wanted to hold. All infants were mechanically ventilated and received sedation-analgesia. Main outcome was change in body temperature (> 34°C or < 33 °C) during PH. Secondary outcomes were change in vital signs and behavior (comfort/pain scores) during PH. Parental and nurses’ opinions were assessed by a self-reporting questionnaire with a 10-point Likert scale.

Results

We found no significant changes in temperature, other vital signs or in infants’ COMFORT-B score during parental holding. Responses to self-reporting questionnaires completed by parents and nurses showed a high level of overall effectiveness and satisfaction with PH.

Conclusion

Parents holding newborns undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy was safe for the newborn without causing discomfort. It was also beneficial for the parents and supported by the healthcare team.

Impact

  • Parents holding newborns undergoing therapeutic hypothermia for Hypoxic Ischemic Encephalopathy was feasible without causing discomfort. It was also beneficial for the parents and supported by the healthcare team.

  • Infants’ temperature or other vital signs did not change during parental holding, which was found very satisfactory by parents and healthcare givers, showing that parental holding is feasible.

  • This study promotes further dissemination of parental holding, which may limit the detrimental effect of physical separation for parents of newborns undergoing therapeutic hypothermia.

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Acknowledgements

We are very grateful to the participating neonates and their parents.

Funding

This study was funded by the Strasbourg University Hospital.

Author information

Authors and Affiliations

  1. Department of Neonatal Medicine, University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France

    Lucas Gançarski, Claire Langlet-Muteau, Jennifer Rondel, Benoît Escande, Claire Koenig-Zores & Pierre Kuhn

  2. Laboratoire des Neurosciences Cognitives et Adaptatives, UMR 7364, National Center of Scientific Research (CNRS), University of Strasbourg, Strasbourg, France

    Jennifer Rondel, Claire Koenig-Zores & Pierre Kuhn

  3. Neonatal Research Unit, Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden

    Pierre Kuhn

Authors
  1. Lucas Gançarski
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  2. Claire Langlet-Muteau
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  4. Benoît Escande
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  5. Claire Koenig-Zores
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  6. Pierre Kuhn
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Contributions

Dr Lucas Gançarski collected data, carried out the initial analysis, drafted the initial manuscript and revised the manuscript. Dr Claire Langlet-Muteau conceptualized and designed the study, collected data, critically reviewed the manuscript. Drs Jennifer Rondel, Benoit Escande and Claire Koenig-Zores conceptualized the study and collected data. Pr Pierre Kuhn conceptualized and designed the study and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Pierre Kuhn.

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The authors have no conflicts of interest relevant to this article to disclose.

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Written informed consent was obtained from the parents. Parents were informed that collected data may be used for publications in scientific journals.

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Gançarski, L., Langlet-Muteau, C., Rondel, J. et al. Physiological and behavioral stability of newborns on therapeutic hypothermia for hypoxic-ischemic encephalopathy during parental holding. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-03812-9

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  • DOI: https://doi.org/10.1038/s41390-025-03812-9

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