Lode-Kolz Karoline, Hermansson Charlotte, Linnér Agnes, Klemming Stina, Hetland Hanne Brit, Bergman Nils, Lilliesköld Siri, Pike Hanne Markhus, Westrup Björn, Jonas Wibke, Rettedal Siren
Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.
Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
Acta Paediatr. 2023 May;112(5):934-941. doi: 10.1111/apa.16590. Epub 2022 Nov 18.
To investigate the impact of immediate skin-to-skin contact with a parent after birth on thermal regulation in very preterm infants.
This clinical trial was conducted in three neonatal intensive care units in Scandinavia from 2018 to 2021. Infants born between 28 + 0 and 32 + 6 weeks and days of gestation were randomised to immediate skin-to-skin contact or conventional care in an incubator during the first 6 postnatal hours. We report on a secondary outcome: serial measurements of axillary temperature.
Ninety-one infants were randomised to skin-to-skin contact or conventional care. Mean (range) gestational ages were 31 + 2 (28 + 6, 32 + 5) and 31 + 0 (28 + 4, 32 + 6) weeks and days, mean birth weights were 1572 (702, 2352) and 1495 (555, 2440) grams, respectively. Mean (95%CI, p-value) temperatures were within the normal range in both groups, 0.2°C (-0.29, -0.14, p < 0.001) lower in the skin-to-skin contact group. The skin-to-skin contact group had a lower relative risk (95%CI, p-value) of developing events of hyperthermia, RR = 0.70 (0.50, 0.99, p = 0.04).
Very preterm infants, irrespective of clinical stability, do not develop hypothermia during immediate skin-to-skin contact after birth. Immediate skin-to-skin contact did protect against events of hyperthermia. Concerns about thermal regulation should not limit implementation of immediate skin-to-skin contact in high-resource settings.
探讨出生后立即与父母进行皮肤接触对极早产儿体温调节的影响。
该临床试验于2018年至2021年在斯堪的纳维亚半岛的三个新生儿重症监护病房进行。孕周在28+0至32+6周之间的婴儿在出生后的前6小时被随机分为立即进行皮肤接触组或在暖箱中进行常规护理组。我们报告一个次要结果：腋窝温度的系列测量值。
91名婴儿被随机分为皮肤接触组或常规护理组。平均（范围）孕周分别为31+2（28+6，32+5）周和31+0（28+4，32+6）周，平均出生体重分别为1572（702，2352）克和1495（555，2440）克。两组的平均（95%置信区间，p值）体温均在正常范围内，皮肤接触组低0.2°C（-0.29，-0.14，p<0.001）。皮肤接触组发生体温过高事件的相对风险（95%置信区间，p值）较低，RR=0.70（0.50，0.99，p=0.04）。
极早产儿，无论临床稳定性如何，在出生后立即进行皮肤接触期间不会发生体温过低。立即进行皮肤接触确实能预防体温过高事件。对体温调节的担忧不应限制在资源丰富的环境中实施立即进行皮肤接触。
