464 - Impact of Immediate Kangaroo Mother Care and Delayed Cord Clamping on Oxygen Saturation and Heart Rate in Moderate and Late Preterm Infants

Publication Number: 1446.464

Alvaro Solaz Garcia, Health Research Institute La Fe, Valencia, Comunidad Valenciana, Spain; Marta Aguar Carrascosa, La Fe University Hospital, Valencia, Comunidad Valenciana, Spain; Alejandro Pinilla-Gonzalez, Hospital la Fe, Valencia, Comunidad Valenciana, Spain; Pilar sáenz González, Health Research Institute La Fe, Valencia, Comunidad Valenciana, Spain; Raquel Escrig-Fernández, Hospital Universitari i Politècnic La Fe, LLIRIA, Comunidad Valenciana, Spain; Maria Cernada, University and Polytechnic La Fe Hospital, Valencia, Comunidad Valenciana, Spain; Laura Torrejón Rodríguez, La Fe Research Institute, Valencia, Comunidad Valenciana, Spain; Laura Collados-Gómez, Universidad Complutense de Madrid, Madrid, Madrid, Spain; Maximo Vento, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Comunidad Valenciana, Spain; Nerea Valles Murcia, Hospital Universitario y Politécnico La Fe, La Fe Health Research Institute, Valencia, Comunidad Valenciana, Spain

Background: Immediate skin-to-skin contact and delayed umbilical cord clamping are evidence-based interventions that independently promote a more stable physiological transition to the extrauterine environment. Skin-to-skin contact facilitates thermoregulation, autonomic maturation and cardiorespiratory stabilisation, while delayed clamping allows for more complete placental transfusion, contributing to better oxygenation and haemodynamic stability. However, evidence regarding the combined effect of both interventions in moderate and late preterm infants is limited.

Objective: To analyse the combined effect of immediate skin-to-skin contact and delayed cord clamping on oxygen saturation and heart rate during the first 10 minutes of life in moderate and late preterm infants.

Design/Methods: Prospective observational study conducted in a tertiary hospital, including 96 newborns between 32+0 and 36+6 weeks of gestation, without requiring resuscitation manoeuvres at birth. Physiological data were recorded by continuous preductal pulse oximetry with high resolution sampling (every 2 seconds), during the first 10 postnatal minutes. The intervention group (n=62) received immediate skin-to-skin contact together with cord clamping >30 seconds, while the control group (n=34) only received delayed clamping. Strict quality controls (perfusion index ≥1.7) were applied and analyses were adjusted for gestational age, birth weight, type of delivery and other confounding factors.

Results: The group receiving both interventions had more favourable physiological adaptation. A non-significant trend towards higher oxygen saturation was evident at all time points analysed (76.06% vs 70.98% at 120 s; 95.13% vs 93.77% at 420 s; p=0.082). For heart rate, statistically significant differences were observed in favour of the intervention group (102.2 vs 87.1 bpm at 120 s; 127.3 vs 112.2 bpm at 420 s; p=0.013). These differences persisted after multivariate adjustment, suggesting that the combined application of both strategies could optimise immediate neonatal haemodynamic adaptation.

Conclusion(s): The combination of immediate Kangaroo Mother Care and delayed cord clamping improves hemodynamic stability and neonatal adaptation in late preterm infants. iKMC was associated with a significant increase in heart rate and a trend toward higher SpO₂ levels. These findings support the potential benefits of combining these interventions to enhance neonatal outcomes. Further studies are needed to assess their long-term clinical implications.

Figure 1. Oxygen saturation (A) and heart rate (B) in neonates subjected to delayed cord clamping and with (iKMC Yes) or without (iKMC No) immediate Kangaroo Mother Care (iKMC) during the first minutes after birth.
Figure 1.pdf