757 - Feasibility and safety of immediate uninterrupted skin-to-skin contact in stable moderate and late preterm neonates

Publication Number: 757.5089

Sushma Nangia, Lady Hardinge Medical College & Kalawati Saran Children's Hospital, New Delhi, Delhi, India; NEHA AGRAWAL, Lady Hardinge Medical College, New Delhi, INDIA, NOIDA, Uttar Pradesh, India; Tapas Bandyopadhyay, ABVIMS & Dr. RML Hospital, New Delhi, Delhi, India; Pratima anand, Lady hardinge medical, New Delhi, Delhi, India

Background: Skin-to-skin contact (SSC) at birth includes placing a newborn directly on the mother's bare chest, for at least an hour immediately after birth. Although, this practice is recommended for all term neonates with good muscle tone and effective breathing. However, neonates born preterm even if breathing at birth are immediately separated from the mother, placed under a radiant warmer, and administered initial steps. Although, studies evaluating the feasibility and safety of early SSC initiated 30 minutes after stabilization at birth found it to reduce the risk of hypothermia but the role of immediate SSC at birth in preterm neonates is still unexplored.

Objective: To assess the safety and feasibility of uninterrupted SSC in singleton, vaginally delivered moderate and late preterm (32-36+6 weeks) neonates initiated immediately after birth for one hour.

Design/Methods: In this prospective observational study, 385 preterm neonates (32-36+6 weeks) born vaginally and breathing or crying at birth were immediately placed on the mother’s bare chest for 1 hour after delayed cord clamping for 60s. The babies were monitored for 180 minutes after birth for thermoregulation and cardiorespiratory stability using the SCRIP score. The breastfeeding rates were also assessed at discharge, 6 weeks, and 12 weeks after birth.

Results: Out of 385 enrolled neonates, 42 (10.9%) babies were moderate and 343 (89%) babies were born late preterm. Total 320 enrolled neonates (83.11%) completed 60 minutes of SSC, more in late-preterm as compared to moderate preterm subgroup (RR 0.692;95% CI 0.537 to 0.891, p< 0.001), respectively. During the first 180 minutes after birth, 326 (84.5%) babies achieved normothermia with the incidence being higher in late preterm as compared to moderate preterm subgroup (RR0.856; 95%CI 0.713-1.03, p0.038). During 60 minutes of SSC, 5 (1.29%) neonates developed significant hypothermia ( < 35.5ºC). The mean SCRIP score rose 45 minutes after birth and there after remained static till 180 minutes at 5.85 with the average SCRIP score being significantly higher in late preterm as compared to moderate preterm subgroup. The proportion of neonates exclusively breastfed at discharge, 6 weeks, and 12 weeks were 382 (99.2%), 254 (87.3%), and 196 (84.8%), respectively with no significant difference in the exclusive breastfeeding rate among moderate and late preterm subgroups, respectively.

Conclusion(s): SSC is a safe and feasible method to achieve thermostability and cardiorespiratory stability among moderate and late preterm neonates immediately after birth.

Maternal and Neonatal demographic characteristics
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Study Outcomes
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