Early skin-to-skin contact and risk of late-onset-sepsis in very and extremely preterm infants.

Autor: Le Ray I; Department of Neonatal Medicine, University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France., Kuhn P; Department of Neonatal Medicine, University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. pierre.kuhn@chru-strasbourg.fr.; Institute of Cellular and Integrative Neurosciences (INCI), UPR 3212, National Center of Scientific Research (CNRS), University of Strasbourg, Strasbourg, France. pierre.kuhn@chru-strasbourg.fr.; Neonatal Research Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden. pierre.kuhn@chru-strasbourg.fr., Letouzey M; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.; Department of Neonatal Pediatrics, Poissy Saint Germain Hospital, Poissy, France., Roué JM; Department of Neonatal Medicine, University Hospital of Brest, Brest, France., Mitha A; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.; Pediatric and Neonatal Intensive Care Transport Unit, Department of Emergency Medicine, SAMU 59, Lille University Hospital, Lille, France., Glorieux I; Neonatal Intensive Care Unit, Children Hospital, Toulouse University Hospital, Toulouse, France., Foix-L'Hélias L; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.; Department of Neonatal Pediatrics, Trousseau Hospital, APHP, Paris Sorbonne University, Paris, France., Marchand-Martin L; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France., Ancel PY; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France., Kaminski M; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France., Pierrat V; Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.; CHU Lille, Department of Neonatal Medicine, Jeanne de Flandre Hospital, F-59000, Lille, France.
Jazyk: angličtina
Zdroj: Pediatric research [Pediatr Res] 2023 Jun; Vol. 93 (7), pp. 2091-2100. Date of Electronic Publication: 2022 Nov 14.
DOI: 10.1038/s41390-022-02383-3
Abstrakt: 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: 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: 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: 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: 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.
(© 2022. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)
Databáze: MEDLINE
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