Background: Skin-to-skin care immediately following delivery is a common practice for term infants and has been\nshown to improve cardiorespiratory stability, facilitate early bonding, and promote breastfeeding. Since 2007, the\nuse of skin-to-skin care has been practiced for preterm infants from 32 weeks of gestation in the delivery room at\nSt. Olavââ?¬â?¢s University Hospital. In the present study we aim to investigate whether skin-to-skin care following delivery\nis safe, and how it affects early and late outcomes compared to standard care for very preterm infants.\nMethods/Design: A randomized controlled trial (RCT) of skin-to-skin care in the delivery room for very preterm\ninfants born at gestational age 280ââ?¬â??316 weeks with birth weight >1000 grams. Infants with severe congenital\nmalformations or need of intubation in the delivery room are excluded. A detailed checklist and a flowchart were\nprepared for the study, and all involved professionals (neonatologists, neonatal nurses, obstetricians, anesthesiologists,\nmidwives) participated in medical simulation training prior to study start on February 1, 2014. A consultant in\nneonatology and a neonatal nurse are present at all deliveries. Infants with birth weight <1500 grams receive\nan intravenous line with glucose, amino acids, and caffeine citrate in the delivery room. Infants with gestational\nage <30 weeks are routinely put on continuous positive airway pressure (CPAP). After initial stabilization, infants are\nrandomized to skin-to-skin care or are transferred to the nursery in an incubator. Primary outcome is cognitive\ndevelopment at 2 years measured with the Bayley Scales of Infant Development, Third Edition. Secondary outcomes\nare safety defined as hypothermia, respiratory failure, and/or cardiopulmonary resuscitation, physiological stability\nafter birth and motor, language and cognitive development at 1 year for the child, and mental health measured\nwith the State-Trait Anxiety Inventory (STAI) at discharge, and at 3 months and 2 years after expected date of\ndelivery for the mothers.\nDiscussion: The study may have important implications for the initial care for very preterm infants after delivery\nand increase our understanding of how early skin-to-skin care affects preterm infants and their mothers.
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