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

Kathrin Hanke; Tanja K Rausch; Runa Sosnowski; Pia Paul; Juliane Spiegler; Mirja Müller; Inke R König; Wolfgang Göpel; Egbert Herting; Christoph Härtel

doi:10.3390/children9020211

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

Children (Basel). 2022 Feb 6;9(2):211. doi: 10.3390/children9020211.

Authors

Affiliations

¹ Department of Pediatrics, University of Lübeck, D-23538 Lüebeck, Germany.
² Institut für Medizinische Biometrie und Statistik, University of Lübeck, D-23538 Lübeck, Germany.
³ Department of Pediatrics, University of Würzburg, D-97080 Würzburg, Germany.

Abstract

Aim: It was the aim of our study to determine the regional cerebral tissue oxygenation saturation (rcSO₂) 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 rcSO₂ 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 rcSO₂ 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, rcSO₂ 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 rcSO₂ 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 FiO₂ adjustment was required in the vast majority of SSC episodes.

Conclusions: Our observational data indicate that rcSO₂ values of infants during SSC were comparable to rcSO₂ values during incubator care and resting time. This additional monitoring supports a safe implementation of early SSC in extremely preterm infants in NICUs.

Keywords: near infrared spectroscopy; preterm infants; regional cerebral oxygenation saturation; skin-to-skin contact.

Publication types

Review