Early skin-to-skin contact between healthy late preterm infants and their parents: an observational cohort study.

Background: Skin-to-skin contact (SSC) is an important factor to consider in the care of late preterm infants (born between 34 0/7 and 36 6/7 completed weeks of gestation). The literature suggests that SSC between preterm infants and their mothers facilitates breastfeeding. However, more studies are needed to explore potential dose-response effects between SSC and breastfeeding as well as studies that explicitly investigate SSC by fathers among late preterm infants. The aim was to investigate the duration of healthy late preterm infants' SSC with the mother and father, respectively, during the first 48 h after birth and the associations with breastfeeding (exclusive/partial at discharged), clinical and demographic variables.

Methods: This was an observational cohort study in which parents to healthy late preterm infants, born between 34 5/7 and 36 6/7 completed weeks of gestation, recorded duration of SSC provided by mother and father, respectively. Demographic and clinical variables were retrieved from the medical records and were used as predictors. Multiple linear regression analysis was used to assess the association between the predictors and the outcome, SSC (hours), separately for mothers and fathers.

Results: The mean (standard deviation [SD]) time per day spent with SSC with mothers ( n  = 64) and fathers ( n  = 64), was 14.7 (5.6) and 4.4 (3.3) hours during the first day (24 h) after birth and 9.2 (7.1) and 3.1 (3.3) hours during the second day (24 h), respectively. Regarding SSC with mothers, no variable was significantly associated with SSC during the first day, while the mean (95% confidence interval [CI]) time of SSC during the second day was 6.9 (1.4-12.4) hours shorter for each additional kg of birthweight ( p  = 0.014). Concerning SSC with fathers, the mean (95% CI) time of SSC during the first day was 2.1 (0.4-3.7) hours longer for infants born at night ( p  = 0.015), 1.7 (0.1-3.2) hours longer for boys ( p  = 0.033), 3.2 (1.2-5.2) hours longer for infants born by caesarean section ( p  = 0.003), and 1.6 (0.1-3.1) hours longer for infants exclusively breastfed at discharge ( p  = 0.040). During the second day, the mean (95% CI) time of SSC with fathers was 3.0 (0.6-5.4) hours shorter for each additional kg of birthweight ( p  = 0.014), 2.0 (0.5-3.6) hours longer for infants born during night-time ( p  = 0.011), 2.9 (1.4-4.4) hours longer if the mother was primipara ( p  < 0.001), and 1.9 (0.3-3.5) hours shorter if supplementary artificial milk feeds were given. None of the other predictors, i.e., mother's age, gestational age, or induction of labor were significantly associated with infants' SSC with mothers or fathers during any of the first two days after birth.

Conclusion: Future studies are warranted that investigate duration of SSC between late preterm infants and their parents separately and the associations with breastfeeding and other variables of clinical importance.