650 - Measuring the Effect of Skin-To-Skin Contact on Vital Signs for Preterm Infants in the NICU.

Publication Number: 4636.650

John M. Perry, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Cameron N. Boyd, Cook Children's Medical Center, Fort Worth, TX, United States; Sofia Zitella, Northwestern University The Feinberg School of Medicine, Long Grove, IL, United States; Craig Garfield, Lurie Children's Hospital of Chicago, Chicago, IL, United States; Susan M. Slattery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Gustave H. Falciglia, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States

Background: The positive effects of parental skin-to-skin contact (SSC) through methods like kangaroo care on parental-infant bonding and infant development is well established. The impact of SSC time on physiologic measurements has been reported for term infants, with the beneficial impacts of maintenance of temperature and improvement in oxygen saturation. There is a deficit of knowledge on changes in vital signs for premature infants related to SSC time.

Objective: To measure the impact of SSC on vital sign measurements during and after SSC time for premature infants.

Design/Methods: This study is a retrospective analysis of preterm infants admitted to an urban single-center Level III NICU between the years of 2018-2024. Infants were included in the study if they were born at < 35 weeks gestational age (GA), were admitted for a minimum of 2 days, and had SSC occurrences documented with both a start and stop time. Data on EHR-derived vital sign measurements were collected for before, during, and after each SSC occurrence and the mean value was calculated. Vital signs included heart rate (HR, beats per minute [bpm]), respiratory rate (RR, breaths pm [brpm]), oxygen saturation (O2 sat [%]), and core temperature (Fahrenheit [°F]). Vitals were categorized in the pre-SSC period as anything before the start time, in the SSC period as anything between SSC start and stop time, and in the post-SSC period as 1-4 hours following SSC end time. The association between SSC period and vitals were compared using mixed effects linear regression to account for repeated measures and adjusted for corrected GA.

Results: 1,902 infants met inclusion criteria with 16,264 SSC occurrences. The median GA was 33.1 weeks (interquartile range [IQR]: 31.1, 34.1), median birth weight was 1845 grams (IQR: 1420, 2200), and 47.5% were female sex. The mean HR increased during SSC by 4.4 bpm (p < 0.001) and remained increased by 3.8 bpm (p < 0.001) post-SSC. During SSC, the mean RR decreased by 1.5 brpm (p < 0.001) and remained decreased by 1.3 brpm (p < 0.001) post-SSC. The mean O2 sat increased by 0.4% (p < 0.001) during SSC and remained increased by 0.4% (p < 0.001) post-SSC. During SSC, the mean temperature increased by 0.02°F (p=0.006), but did not remain significantly elevated post-SSC (p=0.803).

Conclusion(s): When adjusted for GA, premature infants showed an increase in HR, a decrease in RR, a decrease in O2 sat, and stable temperature during and after SSC. These findings suggest improved cardiorespiratory regulation with SSC, which may help explain the positive effects SSC has on thermoregulation, a key marker of physiologic stability in prematurity.

Changes in Mean Vital Signs for Premature Infants During and After Skin-to-Skin Contact.
(*) denotes a statistically significant difference compared to the pre-SCC measurement.