Is Skin-to-Skin Care Helpful for Preterm Infants and Their Mothers After Birth?

NCT ID: NCT00917085

Last Updated: 2009-08-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

1996-07-31

Study Completion Date

2001-12-31

Brief Summary

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To see if infant outcomes will improve when mothers are helped to hold their preterm infants skin-to-skin as soon as possible after birth and as often as possible and for as long as possible each time during the next five days.

Detailed Description

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A similar intervention was studied in a RCT with fullterm infants but this was done with emphasis on close contact rather than skin-to-skin contact and lasted only the first 6 hours postbirth. This study was conducted by the same PI and funded by the National Center for Nursing Research, NIH 1990-1994. This research yielded numerous significant and beneficial differences.

Two pilot studies were done with healthy late preterm infants and mothers who planned to breastfeed. Skin-to-skin contact began in the delivery room. The first pilot was a descriptive exploratory study with 10 mother-infant dyads done in Cali, Colombia; skin-to-skin began at birth and lasted through hour 6 when all dyads went to the postpartum ward. Follow-up was through hospital discharge on the second day. All outcomes were positive.

The second pilot was an RCT done in the United States with a well balanced sample of 8 dyads, 4 in each group. Mean observation time lasted 47 hours (Medicaid required discharge time for the mothers) with skin-to-skin contact occurring 84% of the time. All outcomes favored the skin-to-skin group, for example 3.8 days to discharge home compared to 14.5 for the controls. Follow-up was at one year and similarly positive.

Similar differences were hypothesized for the RCT reported here in which the intervention was extended to the care of somewhat smaller and sicker preterm infants and lasted five days unless the infant was discharged sooner. The consent form was in layman terms, four pages long, and fulfilled all the requirements of the Institutional Review Boards of the Bolton School of Nursing at Case Western Reserve University, University Hospitals Case Medical Center and its General Clinical Research Center, and Kadlec Medical Center, Richmond, WA.

Conditions

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Moderate to Late Prematurity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Control group

Control infants received the same standard care as infants who were not in the study. Infants were kept warm in incubators or warmer beds and were wrapped in blankets when held by their mothers. Hospital staff was responsible for providing standard care.

Group Type NO_INTERVENTION

No interventions assigned to this group

Skin-to-Skin group

Group Type EXPERIMENTAL

Skin-to-Skin contact

Intervention Type BEHAVIORAL

Infants in the Skin-to-Skin group also had standard care provided by hospital staff. In addition, the researchers facilitated skin-to-skin contact by placing diaper-clad infants prone between their mothers' breasts as soon as possible after birth. Thereafter the infants and their mothers experienced skin-to-skin contact as often as possible and for as long as possible each time throughout the protocol.

Interventions

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Skin-to-Skin contact

Infants in the Skin-to-Skin group also had standard care provided by hospital staff. In addition, the researchers facilitated skin-to-skin contact by placing diaper-clad infants prone between their mothers' breasts as soon as possible after birth. Thereafter the infants and their mothers experienced skin-to-skin contact as often as possible and for as long as possible each time throughout the protocol.

Intervention Type BEHAVIORAL

Other Intervention Names

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Kangaroo Care

Eligibility Criteria

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Inclusion Criteria

Mother and Infant Dyads

Infants:

* singleton birth
* 32 to 36 completed weeks
* 5-minute Apgar score of 6 or more
* weighed 1300 to 3000 grams
* no birth defects that would interfere with feeding
* healthy enough to experience skin-to-skin contact with their mothers.

Mothers:

* 18 or more years of age
* spoke English
* free of serious drug abuse
* well enough to experience skin-to-skin contact with their infants with assistance if needed.

Exclusion Criteria

Infants:

* too ill to be with their mothers
* who have a condition that interferes with feeding.

Mothers:

* who are too ill to care for their infant
* are serious drug abusers.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Nursing Research (NINR)

NIH

Sponsor Role lead

Responsible Party

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Case Western Reserve University

Principal Investigators

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Gene C Anderson, PhD, RN, FAAN

Role: PRINCIPAL_INVESTIGATOR

Case Western Reserve University

Locations

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University Hospitals Case Medical Center

Cleveland, Ohio, United States

Site Status

Kadlec Medical Center

Richmond, Washington, United States

Site Status

Countries

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United States

References

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Moran M, Radzyminski SG, Higgins KR, Dowling DA, Miller MJ, Anderson GC. Maternal kangaroo (skin-to-skin) care in the NICU beginning 4 hours postbirth. MCN Am J Matern Child Nurs. 1999 Mar-Apr;24(2):74-9. doi: 10.1097/00005721-199903000-00006.

Reference Type BACKGROUND
PMID: 10083783 (View on PubMed)

Anderson GC, Dombrowski MA, Swinth JY. Kangaroo care: not just for stable preemies anymore. Reflect Nurs Leadersh. 2001;27(2):32-4, 45. No abstract available.

Reference Type BACKGROUND
PMID: 11987376 (View on PubMed)

Dombrowski MA, Anderson GC, Santori C, Burkhammer M. Kangaroo (skin-to-skin) care with a postpartum woman who felt depressed. MCN Am J Matern Child Nurs. 2001 Jul-Aug;26(4):214-6. doi: 10.1097/00005721-200107000-00012.

Reference Type BACKGROUND
PMID: 11452667 (View on PubMed)

Anderson GC, Chiu SH, Dombrowski MA, Swinth JY, Albert JM, Wada N. Mother-newborn contact in a randomized trial of kangaroo (skin-to-skin) care. J Obstet Gynecol Neonatal Nurs. 2003 Sep-Oct;32(5):604-11. doi: 10.1177/0884217503256616.

Reference Type BACKGROUND
PMID: 14565739 (View on PubMed)

Swinth JY, Anderson GC, Hadeed AJ. Kangaroo (skin-to-skin) care with a preterm infant before, during, and after mechanical ventilation. Neonatal Netw. 2003 Nov-Dec;22(6):33-8. doi: 10.1891/0730-0832.22.6.33.

Reference Type BACKGROUND
PMID: 14700180 (View on PubMed)

Hake-Brooks SJ, Anderson GC. Kangaroo care and breastfeeding of mother-preterm infant dyads 0-18 months: a randomized, controlled trial. Neonatal Netw. 2008 May-Jun;27(3):151-9. doi: 10.1891/0730-0832.27.3.151.

Reference Type BACKGROUND
PMID: 18557262 (View on PubMed)

Chiu SH, Anderson GC. Effect of early skin-to-skin contact on mother-preterm infant interaction through 18 months: randomized controlled trial. Int J Nurs Stud. 2009 Sep;46(9):1168-80. doi: 10.1016/j.ijnurstu.2009.03.005. Epub 2009 Apr 10.

Reference Type BACKGROUND
PMID: 19361802 (View on PubMed)

Other Identifiers

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M01RR000080

Identifier Type: NIH

Identifier Source: secondary_id

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2R01NR002444-04A1

Identifier Type: NIH

Identifier Source: org_study_id

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