Effect of Skin-to-Skin Holding on Stress in Mothers of Late-Preterm Infants A Randomized Controlled Trial

Purpose: To examine the effect of skin-to-skin care (SSC) on stress perception between mothers who provided SSC to their late-preterm born infants and mothers who provided blanket holding. Design and Methods: This was a longitudinal 2-group randomized controlled trial of 40 infant-mother dyads recruited from a level 3 neonatal intensive care unit in the upper Midwest. Outcome Measure: Maternal stress was measured using the Parental Stressor : Neonatal Intensive Care Unit (PSS : NICU) scale pre-and post-SSC intervention. Demographic and other mother and infant covariates were extracted from medical records. Physiologic stability was measured by the Stability of the Cardiorespiratory System in Preterm Infants (SCRIP) score. Study personnel used daily logs to track frequency and duration of SSC and holding sessions. Results: The intervention and the control groups had similar pre-(mean +/- standard deviation, 2.34 +/- 0.86 for SSC and 2.94 +/- 0.87 for holding) and post-intervention (mean +/- standard deviation, 2.55 +/- 0.95 for SSC and 2.78 +/- 0.90 for holding) overall stress scores. Hours of SSC holding positively correlated with the change in stress scores for the entire scale (r = 0.58; P =.001), and for infant appearance (r = 0.58; P =.001) and parent role alteration (r = 0.48; P =.02) subscales. This relationship remained significant after controlling for the infant's length of stay and SCRIP score. Implications for Practice: Mothers who provide SSC may experience more stress related to a more facilitated progression in the mother and infant relationship. Implications for Research: The relationship between increased stress and the number of hours of SSC holding warrants further investigation.