Skin-to-skin contact at birth for very preterm infants and symptoms of depression and anxiety in parents during the first year - A secondary outcome of a randomized clinical trial

Abstract

Background: Mental health issues are common in parents to preterm infants. In the neonatal intensive care unit (NICU), skin-to-skin contact (SSC) as an avenue for parent-infant closeness may improve parental mental health. Few studies exist regarding its benefits when initiated immediately postbirth. The aim was to determine the effect of SSC for very preterm infants at birth on parents' mental health, by assessing symptoms of depression and anxiety within the first year.

Methods: The Immediate Parent-Infant Skin-to-Skin Study was a randomized clinical trial conducted 2018-2021 at three NICUs in Sweden and Norway. Very preterm infants (28-33 weeks of gestation) were allocated to standard incubator care or SSC with either parent, initiated at birth and continued throughout the first 6 h. Symptoms of depression and anxiety in parents were assessed with the Edinburgh Postnatal Depression Scale and Spielberger State-Trait Anxiety Inventory.

Results: The study included 91 infants (36 twins [40 %]) and 73 mothers and 73 fathers. Infants had a mean gestational age of 31 + 1 weeks and birthweight of 1534 g. Immediate SSC was found to significantly reduce depression symptoms in mothers and anxiety symptoms in fathers at one week after birth and depression and anxiety symptoms in fathers at term-equivalent age of infant.

Limitations: Limitations include a small sample size and limited background data on prenatal depression and anxiety.

Conclusions: Immediate parent-infant SSC following a very preterm birth may provide a protective effect on parents' mental health and should be supported in the clinical setting, alongside necessary nursing, and medical care.

Keywords: Anxiety; Depression; Parental mental health; Preterm birth; Skin-to-skin contact.