Early skin-to-skin contact and risk of late-onset-sepsis in very and extremely preterm infants.
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
17
08
2022
accepted:
18
10
2022
revised:
12
10
2022
medline:
3
7
2023
pubmed:
15
11
2022
entrez:
14
11
2022
Statut:
ppublish
Résumé
To evaluate the association between exposure to early skin-to-skin contact (SSC) and incidence of late-onset sepsis (LOS) in extremely and very preterm infants. Observational study using the national population-based EPIPAGE-2 cohort in 2011. A propensity score for SSC exposure was used to match infants with and without exposure to SSC before day 4 of life and binomial log regression used to estimate risk ratios and CIs in the matched cohort. The primary outcome was at least one episode of LOS during hospitalization. Secondary outcomes were the occurrence of any late-onset neonatal infection (LONI), LOS with Staphylococcus or Staphylococcus aureus, incidence of LOS and LONI per 1000 central venous catheter days. Among the 3422 included infants, 919 were exposed to early SSC. The risk ratio (RR) for LOS was 0.86 (95% CI, 0.67-1.10), for LONI was 1.00 (95% CI, 0.83-1.21), and for LOS with Coagulase-negative Staphylococcus or Staphylococcus aureus infection was 0.91 (95% CI, 0.68-1.21) and 0.77 (95% CI, 0.31-1.87). The incidence RR for LOS per-catheter day was 0.87 (95% CI, 0.64-1.18). Early SSC exposure was not associated with LOS or LONI risk. Thus, their prevention should not be a barrier to a wider use of SSC. Kangaroo Mother Care decreased neonatal infection rates in middle-income countries. Skin-to-skin contact is beneficial for vulnerable preterm infants but barriers exist to its implementation. In a large population-based study using a propensity score methods, we found that skin-to-skin contact before day 4 of life was not associated with a decreased risk of late-onset-sepsis in very and extremely preterm infants. Early skin-to-skin contact was not associated with an increased risk of any late-onset-neonatal-infection, in particular with staphylococcus. The fear of neonatal infection should not be a barrier to a wider use of early skin-to-skin contact in this population.
Sections du résumé
BACKGROUND
BACKGROUND
To evaluate the association between exposure to early skin-to-skin contact (SSC) and incidence of late-onset sepsis (LOS) in extremely and very preterm infants.
METHODS
METHODS
Observational study using the national population-based EPIPAGE-2 cohort in 2011. A propensity score for SSC exposure was used to match infants with and without exposure to SSC before day 4 of life and binomial log regression used to estimate risk ratios and CIs in the matched cohort. The primary outcome was at least one episode of LOS during hospitalization. Secondary outcomes were the occurrence of any late-onset neonatal infection (LONI), LOS with Staphylococcus or Staphylococcus aureus, incidence of LOS and LONI per 1000 central venous catheter days.
RESULTS
RESULTS
Among the 3422 included infants, 919 were exposed to early SSC. The risk ratio (RR) for LOS was 0.86 (95% CI, 0.67-1.10), for LONI was 1.00 (95% CI, 0.83-1.21), and for LOS with Coagulase-negative Staphylococcus or Staphylococcus aureus infection was 0.91 (95% CI, 0.68-1.21) and 0.77 (95% CI, 0.31-1.87). The incidence RR for LOS per-catheter day was 0.87 (95% CI, 0.64-1.18).
CONCLUSION
CONCLUSIONS
Early SSC exposure was not associated with LOS or LONI risk. Thus, their prevention should not be a barrier to a wider use of SSC.
IMPACT
CONCLUSIONS
Kangaroo Mother Care decreased neonatal infection rates in middle-income countries. Skin-to-skin contact is beneficial for vulnerable preterm infants but barriers exist to its implementation. In a large population-based study using a propensity score methods, we found that skin-to-skin contact before day 4 of life was not associated with a decreased risk of late-onset-sepsis in very and extremely preterm infants. Early skin-to-skin contact was not associated with an increased risk of any late-onset-neonatal-infection, in particular with staphylococcus. The fear of neonatal infection should not be a barrier to a wider use of early skin-to-skin contact in this population.
Identifiants
pubmed: 36376509
doi: 10.1038/s41390-022-02383-3
pii: 10.1038/s41390-022-02383-3
doi:
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2091-2100Investigateurs
Catherine Arnaud
(C)
Antoine Burguet
(A)
Gilles Cambonie
(G)
Laurence Caeymaex
(L)
Olivier Claris
(O)
Catherine Gire
(C)
Bernard Guillois
(B)
Pierre Kuhn
(P)
Bénédicte Lecomte
(B)
Ayoub Mitha
(A)
Hugues Patural
(H)
Jean-Charles Picaud
(JC)
Véronique Pierrat
(V)
Jean-Christophe Roze
(JC)
Jacques Sizun
(J)
Pascal Boileau
(P)
Marine Butin
(M)
Laurence Foix-L'Hélias
(L)
Christèle Gras-Le Guen
(CG)
Gilles Kayem
(G)
Pierre Kuhn
(P)
Mathilde Letouzey
(M)
Elsa Lorthe
(E)
Emeline Maisonneuve
(E)
Ayoub Mitha
(A)
Jeanne Sibiude
(J)
Héloïse Torchin
(H)
Informations de copyright
© 2022. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
Références
Mori, R., Khanna, R., Pledge, D. & Nakayama, T. Meta-analysis of physiological effects of skin-to-skin contact for newborns and mothers. Pediatr. Int. 52, 161–170 (2010).
doi: 10.1111/j.1442-200X.2009.02909.x
pubmed: 19519670
Conde-Agudelo, A. & Diaz-Rossello, J. L. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst. Rev. 8, CD002771 (2016).
Feldman, R., Rosenthal, Z. & Eidelman, A. I. Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biol. Psychiatry 75, 56–64 (2014).
doi: 10.1016/j.biopsych.2013.08.012
pubmed: 24094511
Charpak, N. et al. Twenty-year follow-up of Kangaroo Mother Care versus traditional care. Pediatrics 139, e20162063 (2017).
doi: 10.1542/peds.2016-2063
pubmed: 27965377
Gonya, J., Ray, W. C., Rumpf, R. W. & Brock, G. Investigating skin-to-skin care patterns with extremely preterm infants in the NICU and their effect on early cognitive and communication performance: a retrospective cohort study. BMJ Open 7, e012985 (2017).
doi: 10.1136/bmjopen-2016-012985
pubmed: 28320787
pmcid: 5372108
Pierrat, V. et al. Translating neurodevelopmental care policies into practice: the experience of neonatal ICUs in France-The EPIPAGE-2 Cohort Study. Pediatr. Crit. Care Med. 17, 957–967 (2016).
doi: 10.1097/PCC.0000000000000914
pubmed: 27518584
pmcid: 5049969
Pallas-Alonso, C. R. et al. Parental involvement and kangaroo care in European neonatal intensive care units: a policy survey in eight countries. Pediatr. Crit. Care Med. 13, 568–577 (2012).
doi: 10.1097/PCC.0b013e3182417959
pubmed: 22760425
Morelius, E., Angelhoff, C., Eriksson, J. & Olhager, E. Time of initiation of skin-to-skin contact in extremely preterm infants in Sweden. Acta Paediatr. 101, 14–18 (2012).
doi: 10.1111/j.1651-2227.2011.02398.x
pubmed: 21732975
Stoll, B. J. et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA 292, 2357–2365 (2004).
doi: 10.1001/jama.292.19.2357
pubmed: 15547163
Mitha, A. et al. Neonatal infection and 5-year neurodevelopmental outcome of very preterm infants. Pediatrics 132, e372–e380 (2013).
doi: 10.1542/peds.2012-3979
pubmed: 23878051
Stoll, B. J. et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics 110, 285–291 (2002).
doi: 10.1542/peds.110.2.285
pubmed: 12165580
Stoll, B. J. et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 126, 443–456 (2010).
doi: 10.1542/peds.2009-2959
pubmed: 20732945
Sakaki, H., Nishioka, M., Kanda, K. & Takahashi, Y. An investigation of the risk factors for infection with methicillin-resistant Staphylococcus aureus among patients in a neonatal intensive care unit. Am. J. Infect. Control 37, 580–586 (2009).
doi: 10.1016/j.ajic.2009.02.008
pubmed: 19535174
Ancel, P. Y. & Goffinet, F. EPIPAGE 2: a preterm birth cohort in France in 2011. BMC Pediatr. 14, 97 (2014).
doi: 10.1186/1471-2431-14-97
pubmed: 24716860
pmcid: 3991913
Didier, C. et al. Late-onset neonatal infections: incidences and pathogens in the era of antenatal antibiotics. Eur. J. Pediatr. 171, 681–687 (2012).
doi: 10.1007/s00431-011-1639-7
pubmed: 22134805
Ego, A. et al. [Customized and non-customized French intrauterine growth curves. II – Comparison with existing curves and benefits of customization]. J. Gynecol. Obstet. Biol. Reprod. (Paris) 45, 165–176 (2016).
doi: 10.1016/j.jgyn.2015.08.008
pubmed: 26431620
Buuren, S. V. & Groothuis-Oudshoorn, K. MICE: Multivariate Imputation by Chained Equations in R. J. Stat. Softw. 45, 1–67 (2011).
doi: 10.18637/jss.v045.i03
Austin, P. C. Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. Stat. Med. 28, 3083–3107 (2009).
doi: 10.1002/sim.3697
pubmed: 19757444
pmcid: 3472075
Boundy, E. O. et al. Kangaroo Mother Care and neonatal outcomes: a meta-analysis. Pediatrics 137, 1–16 (2016).
doi: 10.1542/peds.2015-2238
Letouzey, M. et al. Cause of preterm birth and late-onset sepsis in very preterm infants: the EPIPAGE-2 cohort study. Pediatr. Res. 90, 584–592 (2021).
doi: 10.1038/s41390-021-01411-y
pubmed: 33627822
pmcid: 7903216
Casper, C., Sarapuk, I. & Pavlyshyn, H. Regular and prolonged skin-to-skin contact Improves short-term outcomes for very preterm infants: a dose-dependent intervention. Arch. Pediatr. 25, 469–475 (2018).
doi: 10.1016/j.arcped.2018.09.008
pubmed: 30340943
Zaoui-Grattepanche, C., Pindi, B., Lapeyre, F., Huart, C. & Duhamel, A. Skin-to-skin contact with an umbilical venous catheter: prospective evaluation in a level 3 unit. Eur. J. Pediatr. 175, 551–555 (2016).
doi: 10.1007/s00431-015-2665-7
Lamy-Filho, F. et al. Effect of maternal skin-to-skin contact on decolonization of Methicillin-Oxacillin-Resistant Staphylococcus in neonatal intensive care units: a randomized controlled trial. BMC Pregnancy Childbirth 15, 63 (2015).
doi: 10.1186/s12884-015-0496-1
pubmed: 25880822
pmcid: 4374510
Hendricks-Munoz, K. D. et al. Skin-to-skin care and the development of the preterm infant oral microbiome. Am. J. Perinatol. 32, 1205–1216 (2015).
doi: 10.1055/s-0035-1552941
pubmed: 26007311
pmcid: 5550897
Roze, J. C. et al. Assessment of neonatal intensive care unit practices and preterm newborn gut microbiota and 2-year neurodevelopmental outcomes. JAMA Netw. Open 3, e2018119 (2020).
doi: 10.1001/jamanetworkopen.2020.18119
pubmed: 32965499
pmcid: 7512059
Giannoni, E. et al. Neonatal sepsis of early onset, and hospital-acquired and community-acquired late onset: a prospective population-based cohort study. J. Pediatr. 201, 106–114 (2018).
doi: 10.1016/j.jpeds.2018.05.048
pubmed: 30054165
Kristoffersen, L. et al. Early skin-to-skin contact or incubator for very preterm infants: study protocol for a randomized controlled trial. Trials 17, 593 (2016).
doi: 10.1186/s13063-016-1730-5
pubmed: 27955652
pmcid: 5153813
Linner, A. et al. Immediate parent-infant skin-to-skin study (IPISTOSS): study protocol of a randomised controlled trial on very preterm infants cared for in skin-to-skin contact immediately after birth and potential physiological, epigenetic, psychological and neurodevelopmental consequences. BMJ Open 10, e038938 (2020).
doi: 10.1136/bmjopen-2020-038938
pubmed: 32636292
pmcid: 7342825
WHO Immediate KMC Study Group. "Kangaroo Mother Care" and survival of infants with low birth weight. N. Engl. J. Med. 384, 2028–2038 (2021).
doi: 10.1056/NEJMoa2026486
pmcid: 8108485
Linnér, A. et al. Immediate skin-to-skin contact is feasible for very preterm infants but thermal control remains a challenge. Acta Paediatr. 109, 697–704 (2020).
doi: 10.1111/apa.15062
pubmed: 31618466
Linnér, A. et al. Immediate skin-to-skin contact may have beneficial effects on the cardiorespiratory stabilisation in very preterm infants. Acta Paediatr. 111, 1507–1514 (2022).
doi: 10.1111/apa.16371
pubmed: 35466432
Seidman, G. et al. Barriers and enablers of kangaroo mother care practice: a systematic review. PLoS One 10, e0125643 (2015).
doi: 10.1371/journal.pone.0125643
pubmed: 25993306
pmcid: 4439040
Smith, E. R., Bergelson, I., Constantian, S., Valsangkar, B. & Chan, G. J. Barriers and enablers of health system adoption of kangaroo mother care: a systematic review of caregiver perspectives. BMC Pediatr. 17, 35 (2017).
doi: 10.1186/s12887-016-0769-5
pubmed: 28122592
pmcid: 5267363
Yue, J. et al. Barriers and facilitators of kangaroo mother care adoption in five Chinese hospitals: a qualitative study. BMC Public Health 20, 1234 (2020).
doi: 10.1186/s12889-020-09337-6
pubmed: 32791972
pmcid: 7427278