Effects of Immediate Skin-to-Skin Contact in Preterm Infants in High-Resource Settings: A Systematic Review

A landmark trial published in 2021 demonstrated a 25% reduction in neonatal mortality when comparing immediate skin-to-skin contact (iSSC) to conventional care in infants with birthweight 1-1.8 kg in low- and middle-resource settings. New evidence from randomised clinical trials on iSSC in high-resource settings has recently become available. This systematic review aimed to evaluate evidence for immediate/early SSC, defined as initiated within 1 h after birth, versus conventional care in inborn preterm infants in high-resource settings.

Ten electronic databases, including PubMed, Embase, and Cochrane CENTRAL, from 2000 until February 2026, were searched. Randomised clinical trials comparing iSSC to conventional care in inborn preterm infants in high-resource settings were included.

Four randomised clinical trials encompassing 325 infants were included. iSSC was feasible and safe. Cardiorespiratory stability, thermoregulation, breastfeeding practices, maternal-infant interaction, infant stress regulation, and parental mental health outcomes were in favour of the intervention.

This systematic review provides updated evidence on the effectiveness of iSSC for preterm infants admitted to neonatal intensive care units in high resource settings. The findings support that there is a sensitive window in the first hours after birth when preterm infants and parents should not be separated.