Determining the Effect of Circadian Lighting on Premature Infants’ DNA Methylation

Faculty Sponsor

Christina Cavinder




Neonatal Nursing, Nursing Care, Low Stress Nursing Care

ORCID Identifier(s)

0000-0002-7525-3278, 0000-0002-8831-9360, 0000-0002-2854-0637, 0000-0002-9419-5798, 0000-0001-5165-685X, 0000-0002-3038-897X, 0000-0003-1722-4150, 0000-0002-0418-288X, 0000-0001-8257-5796, 0000-0002-4743-7512, 0000-0003-3230-3471, 0000-0002-7402-9311, 0000-0002-0759-2657, 0000-0001-5055-2442

Presentation Type

Oral Presentation

Symposium Date

Spring 4-29-2021



Evidence shows that premature infants in the NICU experiencing stress in the areas of parental detachment, pain, and exposure to noxious stimuli undergo DNA methylation (Montirosso & Provenzi, 2015). These epigenetic changes cause long-term effects similar to PTSD.


The purpose of this study is to determine the effects of evidence-based low-stress nursing care including circadian lighting on premature infants’ DNA methylation levels at SLC6A4 alleles.


The study will be conducted in 3 phases with infants admitted to the level III NICU. The anticipated number of participants is 150 to 200. The first phase includes obtaining a baseline oral swab for DNA in the control group. Phase two begins with evidence-based nursing care. Focus of care will be to reduce pain by low-stress nursing care. After 50 infants’ data are collected, phase three will begin with circadian lighting. The initial swab will be obtained before 2 days of age. The second will be obtained 24 hours before discharge. The baseline swab shows the levels of methylation due to maternal stress passed to the infant. This compares methylation levels from hospitalization to those inherited from mom.


Circadian Lighting, which changes morning, evening, and night helps create a 24- hour cycle with calming light tones to aid in creating their circadian rhythm (Linander et al., 2020). Bright light exposure at night causes DNA methylation changes (Fonken & Nelson, 2016). Environmental lighting affects biological processes and sleep states (Miriam & Ariagno, 2000). Cycled lighting decreases length of hospital stay and increased weight gain (Miriam & Ariagno, 2000). Current research demonstrates stressful events cause DNA changes in premature infants (Montirosso et al., 2016; Montirosso & Provenzi, 2015). This research provides low-stress interventions to infants mitigating DNA changes. DNA methylation is significant to understand the impact of nursing care.

Biographical Information about Author(s)

Christina Cavinder teaches for the VU CONHP. Her area of expertise is pediatrics and infants. She has worked as a staff nurse in a NICU and PICU. As a NP in a NICU she does daily patient management and transports for critical infants. Her research is related to parent decision making in the newborn intensive care unit, and has published her evidence-based practice project regarding palliative care. She is a member of NAPNAP, ANA, NANN, and Sigma Theta Tau. Angela M. Schooley develops nursing education efforts in the PNW undergraduate nursing curriculum. Schooley’s research focus includes neuroprotective care of the preterm infant. Prior to teaching she worked in the NICU at South Bend Memorial Hospital. As a NICU nurse she provided bedside care, acted as a charge nurse, and transporter for critically ill infants. Additional authors include 16 Valparaiso University and 1 Purdue Northwest undergraduate nursing students.

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