Immediate skin contact after birth improves the survival of premature babies


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Continuous skin-to-skin contact that begins immediately after delivery, even before the baby has stabilized, can reduce mortality by 25% in infants with a very low birth weight. This according to a study conducted in low- and middle-income countries coordinated by the WHO on the initiative of researchers from the Karolinska Institute published in The New England Journal of Medicine.

Continuous skin-to-skin contact between the baby and the mother, or “Kangaroo Mother Care” (KMC), is one of the most effective ways to prevent globally. The current recommendation of the World Health Organization (WHO) is that skin-to-skin contact begin as soon as a low birth weight baby is stable enough, which for those weighing less than 2 kg at birth usually takes a few days.

“The idea of ​​giving skin-to-skin contact immediately after birth to very small and unstable babies has had quite strong resistance, but about 75% of deaths occur before the baby has been deemed stable enough,” says Nils Bergman , doctor and researcher. in the Department of Women’s and Children’s Health, Karolinska Institutet, Sweden, and one of the initiators of the study.

The new study, funded by the Bill & Melinda Gates Foundation and led by the WHO, has examined whether immediate care for the kangaroo mother, iKMC, leads to even better survival rates after childbirth. with a birth weight of 1 to 1.8 kg lower and . The study was conducted at five university hospitals in Ghana, India, Malawi, Nigeria and Tanzania, where the mortality of these babies, before the study, ranged from 20 to 30 percent.

To improve and align care as much as possible between study hospitals before the study began, basic neonatal care training was provided and basic equipment was purchased to measure infants ’oxygen levels and provide assisted ventilation. . Participating hospitals also received safe skin-to-skin contact training for unstable infants. KI researchers, supported by a colleague from the University of Stavanger, Norway, were responsible for training and, through frequent site visits, ensuring the quality of basic care in both groups and of the iKMC technique in the intervention group.

In the study, 3,211 babies were randomly assigned to two groups, one who received iKMC and continued skin-to-skin contact in the neonatal unit, where mothers also received their medical care, and one group. control that received standard care, whereby mothers received and babies were cared for in separate units and only gathered during infant feeding. As soon as the babies were sufficiently stabilized, the mothers and babies of both groups were transferred to the usual KMC unit. During the first 72 hours, infants in the iKMC group received approximately 17 hours of skin-to-skin contact per day, compared with 1.5 hours in the control group.

Mortality during the first 28 days was 12% in the iKMC group compared to 15.7% in the control group, which corresponds to a 25% reduction. There were also significantly fewer babies in the iKMC group with low body temperature or bacterial blood poisoning.

“The main message is that low birth weight babies should receive skin to skin immediately after birth and subsequently in a mother-child couple care unit, where and babies are cared for together without having to be separated, “says Björn Westrup, consultant and researcher at the Department of Women’s and Children’s Health, Karolinska Institute and co-initiator of the study with Nils Bergman.” Our results suggest that this model of care, which in itself does not require resources, could have significant effects on health. “

Researchers estimate that iKMC has the potential to save the lives of an additional 150,000 small babies each year.

“Keeping the mother and baby together from birth, with zero separation, will revolutionize the way neonatal intensive care is practiced for babies born early or young,” says Dr. Rajiv Bahl, WHO Head of Maternal and Newborn Health Research and Development and Study Coordinator. “This study illustrates that care for the kangaroo mother has the potential to save many more lives if it is started immediately after birth, a finding relevant to countries of all income levels.”

The WHO is reviewing current recommendations on care for kangaroo mothers, published in 2015, in the light of new evidence. WHO recommends KMC for all babies, but new study provides important evidence on the role that can save KMC’s life immediately .

Skin-to-skin contact does not improve the interaction between mother and premature infant

More information:
Immediate care of the mother kangaroo and survival of low birth weight babies, New England Journal of Medicine (2021). DOI: 10.1056 / NEJMoa2026486

Citation: Skin-to-skin contact immediately after birth improves the survival of premature babies (2021, May 26) recovered on May 26, 2021 at -contact- birth-survival-pre-term.html

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