Supporting Early Skin-to-Skin Care of Infants Born at 22-23 Weeks' Gestation.

AIM: While skin-to-skin care (SSC) early after birth has been demonstrated to promote many benefits in very preterm infants, including thermal stability, less is known about its feasibility in infants born extremely preterm. We aimed to evaluate our practice of initiating SSC in the 1 week of life also in the most immature infants, those born at less than 24 weeks gestation.

METHODS

Retrospective chart review of all inborn infants with a gestational age (GA) of 22+0-23+6 weeks, during a 5-year period (2015-2019) at Uppsala University Hospital, Sweden.

RESULTS

Out of 57 infants, 43 infants (GA 23+1 ± 0.5 weeks; birth weight 520 ± 75 g) had their first SSC in the 1 week of life, at a median (IQR) age of 4 (3; 5) days, when most infants were still receiving mechanical ventilation (93%) and had umbilical catheters (63%). SSC duration was 128 ± 74 min. Significant hypothermia (< 36.0°) occurred in 2/43 (5%). 72% survived.

CONCLUSIONS

In our practice, skin-to-skin care in the 1 week of life is feasible, and in this retrospective study, few infants (5%) experienced hypothermia. Further improvements in the SSC procedure could be expected to further minimise the risk of hypothermia.