Early Skin-to-Skin Contact Does Not Affect Cerebral Tissue Oxygenation in Preterm Infants <32 Weeks of Gestation

Aim: It was the aim of our study to determine the regional cerebral tissue oxygenation saturation (rcSO(2)) as an additional monitoring parameter during early skin-to-skin contact (SSC) in preterm infants with a gestational age of <32 gestational weeks. Methods: We conducted two observational convenience sample studies using additional monitoring with near-infrared spectroscopy (NIRS) in the first 120 h of life: (a) NIRS 1 (gestational age of 26 0/7 to 31 6/7 weeks) and (b) NIRS 2 (gestational age of 24 0/7 to 28 6/7 weeks). The rcSO(2) values were compared between resting time in the incubator (period I), SSC (period II) and handling nursing care (period III). For the comparison, we separated the sequential effects by including a wash-out phase of 1 h between each period. Results: During the first 120 h of life 38/53 infants in NIRS 1 and 15/23 infants in NIRS 2 received SSC, respectively. We found no remarkable differences for rcSO(2) values of NIRS 1 patients between SSC time and period I (95% confidence interval (CI) for the difference in %: SSC vs. period I [1; 3]). In NIRS 2, rcSO(2) values during SSC were only 2% lower compared with period I [median [1. quartile; 3. quartile] in %; 78 [73; 82] vs. 80 [74; 85]] but were similar to period III [78 [72; 83]]. In a combined analysis, a small difference in rcSO(2) values between SSC and resting times was found using a generalized linear mixed model that included gender and gestational age (OR 95% CI; 1.178 [1.103; 1.253], p < 0.0001). Episodes below the cut-off for hypoxia; e.g., <55%, were comparable during SSC and periods I and III (0.3-2.1%). No FiO(2) adjustment was required in the vast majority of SSC episodes. Conclusions: Our observational data indicate that rcSO(2) values of infants during SSC were comparable to rcSO(2) values during incubator care and resting time. This additional monitoring supports a safe implementation of early SSC in extremely preterm infants in NICUs.

Automated summary

The aim of this study was to determine the cerebral tissue oxygenation saturation (rcSO(2)) during early skin-to-skin contact (SSC) in preterm infants. The results showed that the rcSO(2) values during SSC were comparable to those during incubator care and resting time. This suggests that the additional monitoring supports safe implementation of SSC in extremely preterm infants in NICUs.