218 - Immediate skin to skin contact after birth between a very premature born infant and a parent, enhances mother-and-child interactions at 4 months IPISTOS (Immediate Infant Parent Skin to Skin) study.

Poster Number: 218
Publication Number: 218.230

Background: Prematurity is associated with difficulties regulating socio-emotional behavior. The early-life stress of premature birth, the environment of the neonatal intensive care unit, and maternal separation might affect the developing brain and long-term outcome with an atypical regulation of emotions.

Objective: To determine if skin-to-skin contact immediately after birth and continuously during the 6 first hours between parent and very preterm born infant impacts mother and infant interaction during a stressful exposure at 4 months corrected age.

Design/Methods: The Immediate Parent-Infant Skin-To-Skin Study is a randomized clinical trial conducted in three neonatal intensive care units in Scandinavia from 2018 to 2021. Infants born in gestational ages (GA; weeks+days) 28+0-32+6 were randomized to immediate skin-to-skin contact after birth with a parent or conventional care in incubator during the first 6 postnatal hours. At 4 months corrected age the still-face paradigm (SF) was performed. Mothers and infants were video recorded with the infant facing the mother. SF included 2 min face-to-face play interaction, 2 min SF interaction where the mothers held an expressionless face to their infants while looking at them, but not smiling, talking, or touching them, and a 2 min reunion play interaction. Videos of interaction were coded by blinded researchers using Global Rating Scale quantifying maternal sensitivity, intrusiveness and remoteness, and infant level of communication, involvement and positive emotionality.

Results: 30 infants randomized to immediate skin-to-skin contact and 31 to conventional care at birth, were included. Median (IQR) GA were 31+4 (30+2, 32+5) and 31+3 (29+2, 32+5), and birth weight 1647 (1441, 1906) g and 1450 (1138, 1762) g. Baseline characteristics were equally distributed between the two groups, except child sex that was adjusted for. Mothers with infants allocated to immediate skin-to-skin at birth were less intrusive during reunion play at 4 months corrected age p(CI)=0.0445 (0.01, 0.56).

Conclusion(s): Skin-to-skin contact in very preterm born infants started immediately at birth and continued for the 6 first postnatal hours as compared to conventional care, enhanced maternal-infant interactions at 4 months corrected age, with less maternal intrusiveness.