Strategies for the humanization of the environment and care processes are essential to reduce the impacts that prolonged hospitalization in the Neonatal Intensive Care Unit (NICU) can cause on the development of premature newborns (PTNB). One of the procedures adopted for these purposes is nest positioning (NP), a method that promotes PTNB containment and facilitates the adoption of flexor postures. However, there is a gap in the literature regarding the effects of nest positioning on weight gain, sleep pattern, motor development and hospital discharge.

To evaluate the effects of NP on motor development, sleep pattern, weight gain and hospital discharge in PTNB admitted to the NICU.

The present study was constructed based on the criteria of the PRISMA guideline (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A systematic search was carried out using search indexes in the following electronic data sources: MEDLINE via PubMed, WEB of SCIENCE, SCOPUS and BVS-BIREME, following the PICOS strategy (P: participants; I: intervention; C: comparison; O: outcomes; S: studies). As eligibility criteria, there was inclusion of studies with populations of PTNB (< 37 gestational weeks from the date of the last maternal menstruation) admitted to the NICU and who used the PN (supine, prone and lateral decubitus) as an intervention strategy in this population. Outcomes related to sleep patterns and weight gain were sought, in addition to others related to motor development. Methodological quality was assessed using the PEDro Scale.

After the selection process, 11 studies were included in the systematic review. Among them, 5 (45.4%) had motor development as the primary outcome, 5 (45.4%) had the sleep-wake cycle pattern as the primary outcome, and 1 (9.2%) study had the primary outcome as the weight gain and, consequently, hospital discharge. According to the PEDro scale, 5 (45.4%) studies had good methodological quality, with scores between 6 and 8, 2 studies (18.2%) had regular methodological quality with a score of 5, and 4 (36.4% ) studies scored 4 or less, showing low methodological quality. Qualitative results indicate that prolonged positioning in the nest with variations in decubitus may be favorable for the acquisition of flexor postures, midline stimulation and increase in total sleep time of PTNBs admitted to the NICU. No adverse effects were reported in relation to the use of PN.

There was no evidence of the effects of PN on weight gain and hospital discharge, but there is evidence to suggest that PN is beneficial for motor development and sleep patterns of PTNB admitted to the NICU.

The results indicate that prolonged positioning in the nest with variations in decubitus can be favorable for the acquisition of flexor postures, midline stimulation and increase in the total sleep time of PTNBs admitted to the NICU.