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Initiation and duration of skin-to-skin contact for extremely and very preterm infants: A register study

Agnes Linnér1,2, Siri Lilliesköld1,2, Wibke Jonas1,3

  • 1Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|June 1, 2022
PubMed

Insights

Skin-to-skin contact for extremely and very preterm infants in Sweden is initiated late and limited in duration during the first week. Practices vary significantly by gestational age, highlighting a need for improved implementation of this vital care.

Area of Science:

  • Neonatal care
  • Pediatrics
  • Developmental biology

Background:

  • Skin-to-skin contact (SSC), also known as Kangaroo Mother Care, is a vital component of neonatal intensive care for preterm infants.
  • Evidence supports SSC's benefits for infant physiological stability, growth, and parental bonding.
  • Current practices in Swedish neonatal units regarding SSC for extremely and very preterm infants require detailed examination.

Purpose of the Study:

  • To describe the current practice of skin-to-skin contact (SSC) for extremely preterm infants (<28 weeks) and very preterm infants (<32 weeks) in Swedish neonatal units.
  • To analyze the initiation time and daily duration of SSC based on gestational age and regional variations.
  • To provide data for potential improvements in SSC implementation in neonatal care.

Main Methods:

  • Retrospective analysis of data from the Swedish Neonatal Quality Register (2020-2021).
  • Inclusion of 1475 infants with a mean gestational age of 28 weeks (range 22-31) and mean birthweight of 1205 g (range 360-2810).
  • Analysis of SSC initiation time (postnatal hours) and daily duration (hours) stratified by gestational age groups and regions.

Main Results:

  • For extremely preterm infants (<28 weeks), median SSC initiation was 88 hours (IQR 48-156), with only 5% receiving SSC on day one.
  • For very preterm infants (<32 weeks), median SSC initiation was 14 hours (IQR 4-36), with 34% receiving SSC on day one.
  • Median daily SSC duration during the first week was low: 0 hours (day 1), 0.7 hours (first 3 days), and 1.6 hours (first 7 days), increasing to 4.4 hours later in hospitalization.

Conclusions:

  • A minority of extremely and very preterm infants experience SSC on the first postnatal day.
  • The daily duration of SSC during the crucial first week of life is less than two hours on average.
  • Significant variations in SSC initiation time and daily duration exist across different gestational ages, indicating a need for standardized protocols.
Abstract

Keywords:
kangaroo mother careneonatal intensive care unitpreterm infantsregister studyskin-to-skin contact

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