Department of Neonatology, Government Medical College Hospital, Chandigarh, India.
Department of Neonatology, Government Medical College Hospital, Chandigarh, India.
Resuscitation. 2023 Aug;189:109840. doi: 10.1016/j.resuscitation.2023.109840. Epub 2023 May 15.
To compare the effect of immediate care at birth in skin-to-skin contact (SSC) or under a radiant warmer on cardiorespiratory stability at 60 minutes of age in moderate-to-late preterm neonates.
In this open-label, parallel-group, randomized controlled trial, neonates born at 33 to 36 weeks of gestation by vaginal delivery and breathing or crying were randomized to receive care at birth in SSC (n = 50) or under a radiant warmer (n = 50). In the SSC group, immediate care at birth including drying and clearing of the airway was provided in SSC over the mother's abdomen. SSC was maintained for an observational period of 60 minutes after birth. In the radiant warmer group, care at birth and post-birth observation was performed under an overhead radiant warmer. The primary outcome of the study was the stability of the cardio-respiratory system in late preterm infants (SCRIP) score at 60 minutes of age.
Baseline variables were similar in the two study groups. The SCRIP score at 60 minutes of age was similar in the two study groups (median: 5.0, IQR: 5-6 vs. 5.0, 5-6). The mean axillary temperature at 60 minutes of age was significantly lower in the SSC group (°C; 36.4 ± 0.4 vs. 36.6 ± 0.4, P = 0.004).
It was feasible to provide immediate care at birth in moderate and late preterm neonates while being positioned in SSC with the mother. However, in comparison to care under a radiant warmer, this did not lead to better cardiorespiratory stability at 60 minutes of age.
Clinical Trial Registry of India (CTRI/2021/09/036730).
比较在皮肤接触（SSC）或辐射保暖器下进行即刻护理对中晚期早产儿出生后 60 分钟时心肺稳定性的影响。
在这项开放标签、平行组、随机对照试验中，阴道分娩且呼吸或哭泣的 33 至 36 孕周新生儿被随机分为 SSC 组（n=50）或辐射保暖器组（n=50），在 SSC 组中，在母亲腹部上方进行 SSC 下的即刻护理，包括干燥和清除气道。SSC 持续到出生后 60 分钟的观察期。在辐射保暖器组中，在头顶辐射保暖器下进行出生时护理和出生后观察。研究的主要结局是晚期早产儿（SCRIP）评分在出生后 60 分钟时的心肺系统稳定性。
两组研究对象的基线变量相似。两组的 SCRIP 评分在 60 分钟时相似（中位数：5.0，IQR：5-6 vs. 5.0，5-6）。60 分钟时 SSC 组的腋温明显较低（°C；36.4±0.4 vs. 36.6±0.4，P=0.004）。
在与母亲保持 SSC 体位的情况下，为中晚期早产儿提供即刻出生护理是可行的。然而，与辐射保暖器护理相比，这并没有导致 60 分钟时更好的心肺稳定性。
印度临床试验注册中心（CTRI/2021/09/036730）。
