Early skin-to-skin contact after cesarean section: A randomized clinical pilot study

Early bonding by skin-to-skin contact (SSC) has been demonstrated to be beneficial for mothers and newborns following vaginal delivery. The aim of this study was to investigate the impact of intraoperative bonding (early SSC) after cesarean section on neonatal adaptation, maternal pain and stress re...

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Veröffentlicht in:	PloS one Jg. 12; H. 2; S. e0168783
Hauptverfasser:	Kollmann, Martina, Aldrian, Lisa, Scheuchenegger, Anna, Mautner, Eva, Herzog, Sereina A., Urlesberger, Berndt, Raggam, Reinhard B., Lang, Uwe, Obermayer-Pietsch, Barbara, Klaritsch, Philipp
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Public Library of Science 23.02.2017 Public Library of Science (PLoS)
Schlagworte:	Adult Amylases Analysis Apgar Score Austria Biology and Life Sciences Biomarkers Body Temperature Bonding Breastfeeding & lactation Cesarean section Cesarean Section - methods Child development Childbirth & labor Clinical trials Female Gynecology Health aspects Health informatics Health risk assessment Heart Rate Hormones Humans Hydrocortisone Hydrocortisone - analysis Infant, Newborn Internal medicine Intervention Kangaroo-Mother Care Method - methods Medicine Medicine and Health Sciences Mother-Child Relations Mother-infant relations Neonates Newborn babies Newborn infants Obstetrics Oxygen Oxygen content Pain Pain Perception Parent-child relations Pediatrics People and Places Physical Sciences Pilot Projects Pregnancy Prospective Studies Saliva - chemistry Salivary alpha-Amylases - analysis Skin Social Sciences Stress Stress response Stress, Physiological Stresses Studies Temperature perception Vagina α-Amylase Austria
ISSN:	1932-6203, 1932-6203
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Zusammenfassung:	Early bonding by skin-to-skin contact (SSC) has been demonstrated to be beneficial for mothers and newborns following vaginal delivery. The aim of this study was to investigate the impact of intraoperative bonding (early SSC) after cesarean section on neonatal adaptation, maternal pain and stress response. This prospective, randomized-controlled pilot study was performed at a single academic tertiary hospital (Department of Obstetrics and Gynecology, Medical University of Graz, Austria) between September 2013 and January 2014. Women were randomly assigned to intraoperative ("early") SCC (n = 17) versus postoperative ("late") SCC (n = 18). Main variables investigated were neonatal transition (Apgar score, arterial oxygen saturation, heart rate and temperature), maternal pain perception and both maternal and neonatal stress response by measuring the stress biomarkers salivary free cortisol and salivary alpha amylase. There was no evidence for differences in parameters reflecting neonatal transition or stress response between the 'Early SSC Group' and the 'Late SSC Group'. Maternal salivary cortisol and alpha-amylase levels as well as maternal wellbeing and pain did not differ between the groups. However, the rise of maternal salivary alpha-amylase directly after delivery was higher in the 'Early SSC Group' compared to the 'Late SSC Group' (p = 0.004). This study did not reveal significant risks for the newborn in terms of neonatal transition when early SSC is applied in the operating room. Maternal condition and stress marker levels did not differ either, although the rise of maternal salivary alpha-amylase directly after delivery was higher in the 'Early SSC Group' compared to the 'Late SSC Group', which may indicate a stressor sign due to intensive activation of the sympathetic-adreno-medullary-system. This needs to be further evaluated in a larger prospective randomized trial. ClinicalTrials.gov NCT01894880.
Bibliographie:	ObjectType-Article-2 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Feature-3 ObjectType-Evidence Based Healthcare-1 ObjectType-Article-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 Competing Interests: The authors have declared that no competing interests exist. Conceptualization: MK EM SAH BU RBR BOP UL PK.Data curation: MK LA AS SAH.Formal analysis: MK SAH.Investigation: MK LA AS EM RBR BOP PK.Methodology: MK LA AS EM SAH BU RBR UL BOP PK.Project administration: MK PK.Software: SAH.Supervision: MK PK.Validation: MK SAH.Visualization: MK SAH.Writing – original draft: MK PK.Writing – review & editing: MK LA AS EM SAH BU RBR UL BOP PK.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0168783