The effect of early, continuous skin-to-skin contact on the mortality of preterm neonates : a systematic literature review

Abstract: Introduction Early skin-to-skin contact is an intervention that involves a newborn lying on their mother’s chest within 24 hours of birth. It has previously been supported to reduce the mortality of preterm infants. Aim The aim of this review is to investigate whether early, continuous skin-to-skin contact affects the mortality of preterm neonates. Method This is a systematic literature review. PubMed, CINAHL, and two meta-analyses were searched for control studies that included the outcome mortality. For studies to be included the intervention they required neonates, with a birthweight of ≤2000g, being placed skin-to-skin within 24 hours of birth for a minimum of six hours. The studies were screened by title, abstract and finally by reading the whole text. The studies were evaluated using either the Risk of Bias tool (RoB 2) or the Risk Of Bias In Non-randomised Studies - of interventions tool (ROBINS-I). Results 620 articles were found when searched for in the databases and meta-analyses. After excluding articles based on title, abstract or the full article, three articles were included. All three presented a reduced mortality, with a percentage decrease between 24 and 43% in the intervention group. Only one article mentioned a statistical significance between the intervention and control groups and had a lower risk of bias. The other two articles did not include a statistical analysis, and both had a high risk of bias. Conclusion This review highlighted the low number of studies on skin-to-skin initiated within 24 hours for a longer period on preterm infants. It also suggests that early, continuous skin-to-skin contact can reduce mortality, but more research is required as this small review cannot draw any large conclusions.