Document Detail

Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns.
MedLine Citation:
PMID:  15244227     Owner:  NLM     Status:  MEDLINE    
AIM: Conventional care of prematurely born infants involves extended maternal-infant separation and incubator care. Recent research has shown that separation causes adverse effects. Maternal-infant skin-to-skin contact (SSC) provides an alternative habitat to the incubator, with proven benefits for stable prematures; this has not been established for unstable or newborn low-birthweight infants. SSC from birth was therefore compared to incubator care for infants between 1200 and 2199 g at birth. METHODS: This was a prospective, unblinded, randomized controlled clinical trial; potential subjects were identified before delivery and randomized by computerized minimization technique at 5 min if eligible. Standardized care and observations were maintained for 6 h. Stability was measured in terms of a set of pre-determined physiological parameters, and a composite cardio-respiratory stabilization score (SCRIP). RESULTS: 34 infants were analysed in comparable groups: 3/18 SSC compared to 12/13 incubator babies exceeded the pre-determined parameters (p < 0.001). Stabilization scores were 77.11 for SSC versus 74.23 for incubator (maximum 78), mean difference 2.88 (95% CI: 0.3-5.46, p = 0.031). All 18 SSC subjects were stable in the sixth hour, compared to 6/13 incubator infants. Eight out of 13 incubator subjects experienced hypothermia. CONCLUSION: Newborn care provided by skin-to-skin contact on the mother's chest results in better physiological outcomes and stability than the same care provided in closed servo-controlled incubators. The cardio-respiratory instability seen in separated infants in the first 6 h is consistent with mammalian "protest-despair" biology, and with "hyper-arousal and dissociation" response patterns described in human infants: newborns should not be separated from their mothers.
N J Bergman; L L Linley; S R Fawcus
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  93     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-07-12     Completed Date:  2004-09-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  779-85     Citation Subset:  IM    
Mowbray Maternity Hospital, Mowbray, South Africa.
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MeSH Terms
Anxiety, Separation / physiopathology*
Birth Weight
Gestational Age
Heart Rate
Incubators, Infant*
Infant Care / methods*
Infant, Low Birth Weight / physiology*
Infant, Newborn
Infant, Premature / physiology*
Mother-Child Relations
Oxygen Consumption
Comment In:
Acta Paediatr. 2004 Jun;93(6):730-3   [PMID:  15244218 ]
Acta Paediatr. 2006 Jan;95(1):15-6   [PMID:  16373290 ]

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