Skin-to-Skin Contact Improves Gas Exchange in Premature Infants

Abstract

OBJECTIVE:

Skin-to-skin contact (kangarooing) is regarded as an important method to improve intensive care in premature infants. There is still demand for investigations of its impact on physiological parameters.

STUDY DESIGN:

We examined 53 preterm infants of <1800 gm in a prospective, pretest-test-posttest design study during incubator care (60 minutes), skin-to-skin contact (90 minutes), and incubator care again (90 minutes). Heart rate, respiratory rate, oxygen saturation (SaO₂), transcutaneous pO₂ (tcpO₂), transcutaneous pCO₂, rectal temperature, and fraction of inspired oxygen were measured.

RESULTS:

The heart rate increased during skin-to-skin contact by 5 beats per minute (p < 0.001), the respiratory rate dropped by 5/minute (p < 0.01), the SaO₂ improved by 0.4% (p < 0.05) accompanied by an increase of tcpO₂ of 4.8 mm Hg (p < 0.001), the tcpCO₂ dropped by 1.2 mm Hg (p < 0.001), and the rectal temperature increased by 0.3 ° C (p < 0.001). Analyzing three groups separately by postnatal weight, we observed the smallest increase in heart rate and the highest decrease in respiratory rate in infants of <1000 gm (p < 0.001). The increase in SaO₂ and in the tcpO₂ doubles in infants of <1000 gm compared with infants of >1000 gm (p < 0.001). All changes were independent of postnatal age.

CONCLUSION: During skin-to-skin contact, preterm infants not only remain clinically stable but also show a more efficient gas exchange. Although the patient is removed (transferred) from the incubator, there is no risk of hypothermia even in infants of <1000 gm.