Regular and prolonged skin-to-skin contact improves short-term outcomes for very preterm infants: A dose-dependent intervention

INTRODUCTION

Skin-to-skin contact (SSC) is a cornerstone of neurodevelopment and family-oriented care for preterm infants. The purpose of the present study was to investigate the effectiveness of skin-to-skin contact in preterm babies depending on regularity, duration, and the period of the first contact.

MATERIALS AND METHODS

This retrospective study involved 26 premature infants with gestational age 24/0-28/6 weeks who were treated in the neonatal intensive care unit and neonatal department. All infants had SSC with their parents.

RESULTS

According to the first SSC, newborns were divided into two groups: group 1 (SSC began in the 1st week of life) and group 2 (SSC began after the 1st week of life). Group A (SSC was performed regularly, i.e., everyday) and group B (SSC was irregular, i.r., once every 2 or 3 days) were based on the regularity of SSC. Depending on the duration of SSC, group І (SSC was more than 3h per day) and group II (SSC was less than 3h per day) were formed. Early SSC correlated with lower incidence of secondary infections (OR=6.75; 95% CI 1.06-42.84; P=0.051), bronchopulmonary dysplasia (OR=10.67; 95% CI 1.70-66.72; P<0.015), and cholestasis (P=0.022). Regular SSC correlated with lower incidence of secondary infections (OR=15.0; 95% CI 1.50-149.70; P=0.014). Duration of SSC was correlated with lower rates of secondary infections (OR=7.00; 95% CI 1.20-40.83; P=0.043) and better rates of breastfeeding (OR=7.00; 95% CI 1.20-40.83; P=0.043).

CONCLUSION

Early, regular, and prolonged SSC has a positive impact on premature infants' health. In particular, early SSC is associated with a reduced risk of BPD development, cholestasis, and nosocomial infection. Prolonged daily skin-to-skin contact is associated with a lower incidence of nosocomial infection and promotes breastfeeding.

Kangaroo mother care can improve the short-term outcomes of very preterm infants

BACKGROUND

Kangaroo mother care (KMC) is a cornerstone of preterm infant management. The purpose of this study was to estimate the effectiveness of daily prolonged KMC in very preterm infants and its influence on neonatal morbidity and short-term outcomes, and breastfeeding optimization.

METHODS

Research included 52 very preterm infants. According to the KMC duration newborns were divided into two groups; Group1 of 22 infants (42.3%) - KMC lasted more than 3 hours/day, Group 2 of 30 infants (57.7%) - KMC lasted less than 3 hours/day.

RESULTS

Nosocomial sepsis occurred less frequently in Group 1 versus Group 2 (OR = 10.50; 95% CI 1.23-89.67, p = 0.012). Incidences of BPD, NEC, IVH I-II grades, the duration of parenteral nutrition, and growth parameters have not been different between groups (p > 0.05). Breastfeeding rates at discharge prevailed in Group 1 (OR = 3.70; 95% CI 1.16-11.86, p = 0.025). The most important factors for nosocomial sepsis: combination of parenteral nutrition duration and daily prolonged KMC, as a preventing factor (p = 0.002). Combination of the neonatal intensive care unit (NICU) treatment duration, type of enteral feeding, and mother's age add as factors that have important influence on breastfeeding prolongation (p = 0.009).

CONCLUSION

Nosocomial infection prevention and breastfeeding optimization are profitable outcomes of daily prolonged KMC in very preterm infants. No significant differences in the BPD, NEC, IVH I-II grades incidences, duration of parenteral nutrition, and growth parameters were found between studied groups. Combination of long-lasting KMC and short-term parenteral nutritionis a significant factor for nosocomial sepsis prophylaxis.

[ABNORMALITIES OF THYROID HORMONE METABOLISM DURING COMMUNITY‒ACQUIRED PNEUMONIA: NONTHYROIDAL ILLNESS SYNDROME AND INTRACELLULAR IODINE DISTRIBUTION IN CHILDREN]

The aim of the study ‒ to investigate the changes of thyroid function and to reveal the relationship in between intracellular distribution of iodine in the blood with the severity of the course of pneumonia in children. We investigated 70 patients in age 6-14 years with moderate and severe CAP and 35 healthy children. The levels of free thyroxine (fT4), free triiodo-thyronine (fT3) and thyroid stimulating hormone, thyroid gland ultrasound and urinary iodine were estimated. Inorganic iodine, total and organificated iodine was investigated. The article presents that severe pneumonia in children is characterized by a transient low level of fT3 2,89 pmol/L (p˂0,05). In a dynamics initially low levels of fT3 raise up to normal data. The general condition and clinical symptoms of the patients was improving after treatment of pneumonia and thyroid status was normalized. Mild iodine deficiency has been established in all children. The intracellular pool of iodine with severe pneumonia showed an inverse relationship between the levels of iodine distribution for organificated and inorganic iodine and a close connection between the levels of total and organic iodine (p<0,001). Nonthyroid illness syndrome developed for patients with severe community-acquired pneumonia. The revealed changes in indices of the intracellular pool of iodine and its distribution in the body are directly proportional to the severity of CAP.