Skin-to-skin contact with an umbilical venous catheter: prospective evaluation in a level 3 unit

Eur J Pediatr. 2016 Apr;175(4):551-5. doi: 10.1007/s00431-015-2665-7. Epub 2015 Nov 19.

Abstract

The aim was to assess the incidence of complications related to skin-to-skin contact (SSC) in newborns with an umbilical venous catheter (UVC). We carried out a prospective follow-up study of all UVCs in a level 3 unit where SSC is systematic. A total of 333 babies were included (mean gestational age of 31.3 weeks (24-41), mean birth weight of 1618 g (454-4900). Two hundred sixty-three babies (78.9 %) had SSC, at a mean postnatal age of 24 h (3-144 h). Two babies presented with a significant umbilical bleeding, all in the first 3 h, before SSC. In 17 cases of UVC leaking, this necessitated an unwanted withdrawal of the UVC; of these, 14 UVCs (82 %) were in sub-hepatic position. In five cases of UVC displacement, babies had no SSC. The overall incidence (3 % [95 % CI = 1.4-5.4]) and incidence density (6.2/1000 UVC-day [95 % CI = 3-11.4]) of catheter-associated infections are similar to those identified by the French multicenter network NEOCAT in 2012 (5 % [95 % CI = 4.1-5.9] and 11.3/1000 UVC-day [95 % CI = 9.3-13.2]).

Conclusion: In this prospective, non-randomized study in a level unit, routine practice of SSC with a UVC does not seem to influence the incidence of mechanical and infectious complications. What is known? • SSC is beneficial for pretem infants. • Fear of mechanical problems and/or infections with a UVC is an obstacle to early use of SSC. What is New: • In this study, SSC for preterm infants with a UVC is associated with low risks of mechanical complications, and does not seem to be associated with any higher risk of catheter-related infections.

Keywords: Catheter-associated bloodstream infection; Kangaroo Mother Care; Skin to skin contact; Umbilical venous catheter.

MeSH terms

  • Catheter-Related Infections / epidemiology*
  • Catheterization, Central Venous / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Prospective Studies
  • Risk Factors
  • Skin
  • Umbilical Veins / surgery*