Effect of cobedding twins on coregulation, infant state, and twin safety

Abstract

Objective: To evaluate the efficacy of cobedding on twin coregulation and twin safety.

Design: Randomized controlled trial (RCT).

Setting: Two university affiliated Level III neonatal intensive care units (NICUs).

Participants: One hundred and seventeen sets (N = 234) of stable preterm twins (<37 weeks gestational age at birth) admitted to the NICU.

Methods: Sets of twins were randomly assigned to be cared for in a single cot (cobedded) or in separate cots (standard care). State response was obtained from videotaped and physiologic data measured and recorded for three, 3-hour sessions over a one-week study period. Tapes were coded for infant state by an assessor blind to the purpose of the study.

Results: Twins who were cobedded spent more time in the same state (p < .01), less time in opposite states (p < .01), were more often in quiet sleep (p < .01) and cried less (p < .01) than twins who were cared for in separate cots. There was no difference in physiological parameters between groups (p = .85). There was no difference in patient safety between groups (incidence of sepsis, p = .95), incidence of caregiver error (p = .31), and incidence of apnea (p = .70).

Conclusions: Cobedding promotes self-regulation and sleep and decreases crying without apparent increased risk.

Keywords: RCT; cobedding; coregulation; infant sleep; multiples; neonatal; preterm; twin.