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. 2020 Mar 6;21(1):46-56.
doi: 10.4274/jtgga.galenos.2019.2018.0138. Epub 2019 Mar 25.

The effect of mother-infant skin-to-skin contact immediately after birth on exclusive breastfeeding: a systematic review and meta-analysis

Fatemeh Zahra Karimi  1   2 , Hamid Heidarian Miri  3 , Talat Khadivzadeh  1   2 , Nahid Maleki-Saghooni  4
Affiliations

The effect of mother-infant skin-to-skin contact immediately after birth on exclusive breastfeeding: a systematic review and meta-analysis

Fatemeh Zahra Karimi et al. J Turk Ger Gynecol Assoc. .

Abstract

In the new millennium, exclusive breastfeeding plays an important role in national and international policies. The effects of mother-infant skin-to-skin contact (SSC) after birth has been investigated in several studies. Given that there has been no overall estimate of this effects, the present study was conducted with the aim of investigating the effects of mother-infant SSC on the rate of exclusive breastfeeding through a systematic review and meta-analysis of randomized controlled trials. In the present study, the databases of Scopus, PubMed, Cochrane, SID, Magiran, IranDoc, and Google Scholar were searched to identify randomized controlled trials that evaluated the effects of mother-infant SSC immediately after birth on the rate of exclusive breastfeeding. The risk of bias and strength of evidence were examined according to the Cochrane Collaboration’s tool and the Grading of Recommendation, Assessment, Development, and Evaluation approach, respectively. The data analysis was performed using Stata software. To assess the publication bias and heterogeneity, Egger’s and Begg’s tests and I2 were used, respectively. In addition, the fixed effects model was employed to perform the meta-analysis. The heterogeneity of the factor of effects in the studies was determined as 16.2% (p<0.303). There was no publication bias among the studies included; the p values of Egger’s and Begg’s tests were 0.168 and 0.386, respectively. The effects of mother-infant SSC on exclusive breastfeeding was statistically significant [odds raito (OR)=2.19; 95% confidence interval (CI): (1.66-2); p<0.001]. The subgroup analysis results in the normal vaginal delivery group included OR=2.45 [95% CI: (1.76-3.35); p<0.001], for the cesarean delivery group the results were OR=1.44 [95% CI: (0.78-2.65); p=0.24], the results for the duration of exclusive breastfeeding as of the discharge time up to 3 months were OR=2.47 [95% CI: (1.76-3.48); p<0.001], and the results for the 3 to 6 months of exclusive breastfeeding were OR=1.71 [95% CI: (1.05-2.78); p=0.030]. The study results showed that mother-infant SSC increased the rate of exclusive breastfeeding. Therefore, this finding could be used by maternal and infant health care providers to develop evidence-based intervention programs.

Keywords: Mother-infant skin-to-skin contact; exclusive breastfeeding; systematic review; meta-analysis.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
The PRISMA flowchart of the study’s selection process PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Figure 2
Figure 2
Author’s judgments of risk of bias items for each study included
Figure 3
Figure 3
Authors’ judgments of risk of bias presented as percentages across all included studies
Figure 4
Figure 4
The funnel plot for the publication bias x-axis is the natural logarithm of the odds ratio and the y-axis is the standard error of the natural logarithm of odds ratio
Figure 5
Figure 5
The effects of mother-infant skin-to-skin contact on exclusive breastfeeding based on the odds ratio. The horizontal lines denote the 95% CI, the Square (□) shows the point estimate (the size of the square corresponds to its weight); the diamond shows (◇) the combined overall effects of treatments. OR: Odds ratio, CI: Confidence interval
Figure 6
Figure 6
The effects of mother-infant skin-to-skin contact on exclusive breastfeeding based on the type of delivery. The horizontal lines denote the 95% CI, the square shows (□) the point estimate (the size of the square corresponds to its weight); the diamond shows (◇) the combined overall effects of treatments OR: Odds ratio, CI: Confidence interval
Figure 7
Figure 7
The effects of mother-infant skin-to-skin contact on exclusive breastfeeding based on the periods of exclusive breastfeeding. The horizontal lines denote the 95% CI, the Square (□) shows the point estimate (the size of the square corresponds to its weight); the diamond shows (◇) the combined overall effects of treatment OR: Odds ratio, CI: Confidence interval
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