Early skin-to-skin contact or incubator for very preterm infants: study protocol for a randomized controlled trial

Kristoffersen, Laila; Støen, Ragnhild; Rygh, Hilde; Sognnæs, Margunn; Follestad, Turid; Mohn, Hilde S.; Nissen, Ingrid; Bergseng, Håkon

doi:10.1186/s13063-016-1730-5

Cited by 25 publications

(35 citation statements)

References 53 publications

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“…In contrast to these strategies, our study is to our knowledge one of the first to focus on the effect of a very early intervention in the delivery room. In contrast to our study focusing on MCI, Kristoffersen et al are currently assessing the impact of DR‐SSC on neurodevelopment in preterm infants . As mentioned before, the first hour after birth represents a sensitive period of mother‐child interaction in which the basis of maternal sensitive behaviour is laid.…”

Section: Discussionmentioning

confidence: 71%

Delivery room skin‐to‐skin contact for preterm infants—A randomized clinical trial

et al. 2019

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Aim To investigate the effects of 60 minutes delivery room skin‐to‐skin contact (DR‐SSC) compared with 5 minutes visual contact (VC) on mother‐child interaction (MCI), salivary cortisol, maternal depression, stress and bonding at 6 months corrected age. Methods A single‐centre randomized controlled trial conducted in a German level III NICU. Eighty‐eight preterm infants (25‐32 weeks of gestational age) were randomized after initial stabilization to either 60 minutes DR‐SSC or 5 minutes VC. Forty‐five infants were allocated to DR‐SSC, 43 to VC. Results Delivery room skin‐to‐skin contact dyads showed a higher quantity of maternal motoric (18 vs 15, P = .030), infant's vocal (7 vs 5, P = .044) and motoric (20 vs 15, P = .032) responses. Moreover, the combined score of maternal and infant responsive behaviour was higher (86 vs 71, P = .041) in DR‐SSC dyads. DR‐SSC mothers had lower risk of both, early postpartum depression (15% vs 45%, P = .003) and impaired bonding (Score 3 vs 5, P = .031). Conclusion In addition to regular intermittent kangaroo mother care, DR‐SSC promotes MCI and decreases risk of maternal depression and bonding problems. Thus, DR‐SSC may have positive effects on preterm development.

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Section: Discussionmentioning

confidence: 71%

Delivery room skin‐to‐skin contact for preterm infants—A randomized clinical trial

et al. 2019

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“…Effective communication and assiduous monitoring are vital throughout. Over the next few years, further evidence regarding the safety and benefits of the DRC will emerge from prospective studies presently underway in centres that have already adopted the practice as routine, and from currently recruiting trials 29,30 . With the inexorable move towards increased FCC, we predict that an early facilitated cuddle between mothers and their extremely preterm babies will in time become standard care for most babies before NICU admission and, furthermore, will become expected by parents.…”

Section: Discussionmentioning

confidence: 99%

“…For the future, we believe that the recent pioneering studies in very preterm infants 16,29,30 pave the way for trials that must include extremely preterm infants. We speculate that eventually their first hour(s) of intensive care will be spent at the maternal bosom, their natural incubator.…”

Section: Conclusion and Futurementioning

confidence: 99%

Delivery room cuddles for extremely preterm babies and parents: concept, practice, safety, parental feedback

et al. 2021

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Aim Following extreme preterm birth, there has traditionally been felt an imperative to rush baby to the neonatal unit for ongoing intensive care. Immediate needs of parents to bond with their babies through direct early physical contact have often been overlooked; many weeks can pass before parents get to hold their babies for the first time. Recognition of the importance of early contact is growing. We aimed to review the safety and value of routinely practising delivery room cuddles for extremely preterm babies. Methods We reviewed delivery room cuddles in babies born <27 weeks’ gestation in our centre between 2006 and 2017 via case‐control. We also conducted a questionnaire survey of mothers who experienced a delivery room cuddle to gain their feedback and perspectives. Results We found no difference in age or temperatures on neonatal unit admission. There was no case of inadvertent extubation associated with cuddles. Parental feedback was very positive. Conclusion With appropriate safeguards, delivery room cuddles are feasible and achievable for extremely preterm babies irrespective of birth gestation. Facilitation of the cuddle is an early and very important family‐centred care practice which seems much appreciated by parents and which may improve bonding, lactation, and maternal mental health.

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“…However, this population could be an interesting target for skin-to-skin transfer. This topic has stimulated great interest, as two randomized controlled trials focusing on the assessment of early SSC with mothers during the extrauterine life adaptation of very preterm infants are ongoing 18,19 .…”

Section: Discussionmentioning

confidence: 99%

Potential benefits and pitfalls of skin-to-skin contact transport from birth room to neonatal unit

Clénet¹,

Carneiro²,

Jeanneaud³

et al. 2021

Preprint

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Background: Early and repeated skin-to-skin contact (SSC) between infants and their parents during neonatal hospitalization has positive effects on maternal bonding, breastfeeding, parent-child interactions and preterm infant neurodevelopmental outcomes.Purpose: Transfers through SSC of newborn infants requiring intensive care over 300 meters between the birth room and neonatal unit have been implemented since 2018. The safety of SSC transfer with the infant’s father was questioned when compared to the more common transfer method in incubators.Methods: Singletons born from May to December 2019 at our three-level maternity ward that required intensive neonatal care were eligible. The infants’ axillary temperature, heart rate, and oxygen need were reported at four timepoints during transfer in an incubator or through SSC and at 30 minutes after arrival in the neonatal unit. Infant characteristics, blood gas, glycemia, time-lapse between birth and first SSC in the unit and feeding modes were also reported.Results: Median gestational age was higher in the SSC group (incubator (n=54): 32 weeks vs SSC (n=57): 36 weeks, p=.003). All infants requiring mechanical ventilation were transported in an incubator. A decrease in temperature was observed during incubator installation in the SSC group (incubator: 0°C vs SSC: -0.2°C, p< .001), but the first SSC in the unit was earlier in this group (incubator: 22 h vs SSC: 11 h, p= .001 and p= .008 after adjustment for gestational age). Implications for practice: Although thermal stability was compromised, encouraging results regarding the first SSC in the unit promote the continuation of SSC transfers.

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Early skin-to-skin contact or incubator for very preterm infants: study protocol for a randomized controlled trial

Cited by 25 publications

References 53 publications

Delivery room skin‐to‐skin contact for preterm infants—A randomized clinical trial

Delivery room skin‐to‐skin contact for preterm infants—A randomized clinical trial

Delivery room cuddles for extremely preterm babies and parents: concept, practice, safety, parental feedback

Potential benefits and pitfalls of skin-to-skin contact transport from birth room to neonatal unit

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