The COVID-19 pandemic has led to a ban on visits with strict restrictions on the presence of parents with their sick newborn children in hospitals. We want to investigate whether the fact that parents are less together with their sick newborn children in the hospital leads to increased stress levels in the newborn children. Stress, in addition to acute and chronic illnesses and medical treatment, can affect the health of newborn children here and now and in the long term (1, 2). We wish to investigate all newborn infants who are admitted to the Newborn Intensive Care Unit at Oslo University Hospital (OUS), Rikshospitalet during the remaining period with restrictions on the parents’ presence in the ward. By comparison, we will use all newborn infants who are enrolled in the Newborn Intensive Care Unit for a correspondingly long period of time after the department returns to normal operation with no restrictions in the presence of parents.

We want to take saliva samples of all inclusive children where the parents consent to this. The saliva sample should be taken with a swab in the mouth morning and evening for three days for each of the children participating in the study. In addition, parents should keep a simple diary in which they write who (mother/father), when and how (by bed/incubator, kept the child, possibly skin-to-skin) they have been with their child during the three days of saliva samples taken. Background information about the child is recorded: Gestational age at birth, chronological and postmenstrual age at sampling, birth weight, current weight at sampling, diagnoses and medical treatment including respiratory support and medication. The saliva samples will be analyzed by mass spectrometric method. We then measure the stress hormones cortisol, cortisone, 11-deoxycortisol and methanephrine. After the visitor ban/restrictions have been lifted and the department is back in normal operation, we will collect the same information and saliva samples for a similar period of time as the restrictions applied.

We want to compare the stress in children, measured by cortisol and other stress hormones in saliva, with and without restrictions in the relationship between parents and their sick newborn children. Our hypothesis is that there may be significant differences in stress hormone levels in children exposed to severe visitor restrictions compared to children who have not been exposed to such restrictions. A simple long-term follow-up is planned, with the sending of an electronic questionnaire to parents / guardians when the child is 24 months corrected age. It is stated in the consent form that we are planning a follow-up study. The parents agree to be contacted for this in a separate check box in the consent form.

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