Comparison of hypothermia in newborns with skin-to-skin contact versus conventional care

Abstract

Neonatal hypothermia is an important contributor to neonatal morbidity and mortality in low resource settings. Skin to skin contact (SSC), a simple and inexpensive intervention has been suggested as a substitute to conventional care (CC) for preventing hypothermia. Evidence, however, is limited on comparing SSC and CC for maintaining neonatal thermoregulation.

Objective: This study compares the hypothermia frequency in neonates given SSC compared with CC, and tests the thermal stability of SSC during the first 24 hours of life.

Methods: It was carried out as a randomized controlled trial at the Department of Obstetrics and Gynecology, Liaquat University of Medical and Health Sciences for a period of six months. Thirty patients were randomised to each of the SSC (n = 30) and CC (n = 30) groups. Multiple intervals up to 24 hours post delivery were measured for axillary temperatures. The main outcome was the incidence of hypothermia, axillary temperature <36.0°C. SPSS 23.0 was used to analyse data with p ≤ 0.05 considered statistically significant.

Results: The incidence of hypothermia was statistically significant lower in the SSC group (10%) than in the CC group (33.3%) (p = 0.028). Across all time points, neonates in the SSC group invariably maintained higher mean temperature than neonates in the EP group, and these differences were significant at 30 minutes, 1 hour, 6 hours, 12 hours, and 24 hours post delivery (p < 0.05). In stratified analysis, neonates with birth weight ≤3.0 kg had the highest benefit from SSC, decreasing the incidence of hypothermia to 10% from 60% in the CC group (p = 0.03).

Conclusion: Neonatal hypothermia incidence is significantly reduced by SSC and sustained thermal stability is maintained during this critical early postnatal period. An low cost effective intervention, and should be incorporated enhancing routine neonatal care, in particular in settings of resources constraints. However, the study stresses the importunities of training programs and community education to encourage the use of SSC as a standard practice.