Early skin-to-skin contact and neurodevelopmental outcome at 5 years in very preterm infants: the Epipage-2 cohort study

BACKGROUND AND AIMS
Long-term effects on neurodevelopment of Skin-to-Skin Contact (SSC) for very preterm infants are still debated. This study aims to evaluate the association of early SSC on neurodevelopmental outcomes at 5½ years among very preterm infants.

METHODS
Using the national population based EPIPAGE-2 cohort, exposure to SSC during the first week of life was evaluated by a propensity score analysis, based on individual and unit characteristics with inverse probability of treatment weighting approach. Outcomes were full-scale-intelligence-quotient (Wechsler Preschool and Primary Scale of Intelligence, 4th edition); behaviour (strengths and difficulties questionnaire); and social communication difficulties (social communication questionnaire) among 2561 infants born between 24 and 31 weeks, and surviving at 5½ years.

RESULTS
Among survivors, 1581 (61.8%) were exposed to SSC during the first week of life (range among neonatal units from 15 to 75%). At 5½ years, SSC was associated with an increased full-scale-intelligence-quotient +1.8 points (+0.0 to +3.6); and with trends for lower scores of behavioural difficulties -0.4 points (-1.1 to +0.4) and social communication difficulties -0.3 points (-0.8 to 0.2).

CONCLUSIONS
Early SSC during the first week of life among very preterm infants was associated with increased full-scale-intelligence-quotient at 5½ years. Variability of practices among units deserves attention. Further evaluation of the dose-effect is needed.