Skin-to-skin contact for the prevention of neonatal hypoglycaemia: a systematic review and meta-analysis.
Skin-to-skin contact for the prevention of neonatal hypoglycaemia: a systematic review and meta-analysis.
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DOI：
10.1186/s12884-023-06057-8
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发表时间：
2023-10-21
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
--
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建议在出生后母婴之间进行皮肤接触，以促进母乳喂养和母婴联系。然而，其对新生儿低血糖发生率的影响尚不清楚。我们进行了系统回顾和荟萃分析来评估这一点。纳入了已发表的随机对照试验（RCT）、准RCT、干预措施的非随机研究、队列研究或皮肤对皮肤护理干预与其他治疗相比的病例对照研究，无语言或日期限制。主要结局为新生儿低血糖（研究定义）。我们检索了从开始到2023年5月12日的4个数据库和4个试验登记研究。使用科克伦偏倚风险1或有效公共卫生实践项目质量评估工具评估研究质量。证据的可靠性采用建议评估、发展和评价分级（GRADE）方法进行评估。使用RevMan 5.4.1或STATA合成结果，并在可能的情况下使用随机效应荟萃分析进行分析，否则使用结果方向表。该综述在PROSPERO（CRD 42022328322）上前瞻性注册。该综述包括108项研究的84，900名参与者，包括65项RCT，16项准RCT，7项非随机干预研究，8项前瞻性队列研究，9项回顾性队列研究和3项病例对照研究。有证据表明，皮肤接触可大幅降低新生儿低血糖的发生率（7项RCT/准RCT，922名婴儿，RR 0.29（0.13，0.66），p < 0.0001，I2 = 47%）。皮肤接触可降低因低血糖而进入特殊护理或新生儿重症监护室的发生率（1项观察性研究，816名婴儿，OR 0.50（0.25-1.00），p = 0.050），但证据非常不确定。皮肤接触可能会减少出生后的首次住院时间（31项RCT，3437名婴儿，MD -2.37（-3.66，-1.08）天，p = 0.0003，I2 = 90%，Egger检验p = 0.02），并增加从出生到出院的纯母乳喂养（1项观察性研究，1250名婴儿，RR 4.30（3.19，5.81），p < 0.0001），但证据非常不确定。皮肤接触可能导致新生儿低血糖的发生率大幅降低。沿着其他已确定的益处，支持所有婴儿，尤其是有低血糖风险的婴儿进行皮肤接触的做法。在线版本包含补充材料，可通过10.1186/s12884-023-06057-8获得。
Skin-to-skin contact between mother and infant after birth is recommended to promote breastfeeding and maternal-infant bonding. However, its impact on the incidence of neonatal hypoglycaemia is unknown. We conducted a systematic review and meta-analysis to assess this. Published randomised control trials (RCTs), quasi-RCTs, non-randomised studies of interventions, cohort, or case–control studies with an intervention of skin-to-skin care compared to other treatment were included without language or date restrictions. The primary outcome was neonatal hypoglycaemia (study-defined). We searched 4 databases and 4 trial registries from inception to May 12th, 2023. Quality of studies was assessed using Cochrane Risk of Bias 1 or Effective Public Health Practice Project Quality Assessment tools. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results were synthesised using RevMan 5.4.1 or STATA and analysed using random-effects meta-analyses where possible, otherwise with direction of findings tables. This review was registered prospectively on PROSPERO (CRD42022328322). This review included 84,900 participants in 108 studies, comprising 65 RCTs, 16 quasi-RCTs, seven non-randomised studies of intervention, eight prospective cohort studies, nine retrospective cohort studies and three case–control studies. Evidence suggests skin-to-skin contact may result in a large reduction in the incidence of neonatal hypoglycaemia (7 RCTs/quasi-RCTs, 922 infants, RR 0.29 (0.13, 0.66), p < 0.0001, I2 = 47%). Skin-to-skin contact may reduce the incidence of admission to special care or neonatal intensive care nurseries for hypoglycaemia (1 observational study, 816 infants, OR 0.50 (0.25–1.00), p = 0.050), but the evidence is very uncertain. Skin-to-skin contact may reduce duration of initial hospital stay after birth (31 RCTs, 3437 infants, MD -2.37 (-3.66, -1.08) days, p = 0.0003, I2 = 90%, p for Egger’s test = 0.02), and increase exclusive breastmilk feeding from birth to discharge (1 observational study, 1250 infants, RR 4.30 (3.19, 5.81), p < 0.0001), but the evidence is very uncertain. Skin-to-skin contact may lead to a large reduction in the incidence of neonatal hypoglycaemia. This, along with other established benefits, supports the practice of skin-to-skin contact for all infants and especially those at risk of hypoglycaemia. The online version contains supplementary material available at 10.1186/s12884-023-06057-8.
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影响因子：
3.8
作者：
CHRISTENSSON, K;CABRERA, T;WINBERG, J
通讯作者：
WINBERG, J
DOI：
10.4102/phcfm.v13i1.2856
发表时间：
2021-08-23
影响因子：
2
作者：
Mathias CT;Mianda S;Ohdihambo JN;Hlongwa M;Singo-Chipofya A;Ginindza TG
通讯作者：
Ginindza TG
影响因子：
4.3
作者：
Kadam, Sandeep;Binoy, S.;Fernandez, Armida
通讯作者：
Fernandez, Armida
影响因子：
2.5
作者：
Harrison, Tondi M.;Chen, Chao-Ying;Heathcock, Jill C.
通讯作者：
Heathcock, Jill C.
DOI：
10.1136/fn.75.2.f130
发表时间：
1996-09-01
影响因子：
4.4
作者：
Karlsson, H
通讯作者：
Karlsson, H