Effects of Immediate Skin-to-Skin Contact in Preterm Infants in High-Resource Settings: A Systematic Review.

AIM: A landmark trial published in 2021 demonstrated a 25% reduction in neonatal mortality when comparing immediate skin-to-skin contact (iSSC) to conventional care in infants with birthweight 1-1.8 kg in low- and middle-resource settings. New evidence from randomised clinical trials on iSSC in high-resource settings has recently become available. This systematic review aimed to evaluate evidence for immediate/early SSC, defined as initiated within 1 h after birth, versus conventional care in inborn preterm infants in high-resource settings. METHODS: Ten electronic databases, including PubMed, Embase, and Cochrane CENTRAL, from 2000 until February 2026, were searched. Randomised clinical trials comparing iSSC to conventional care in inborn preterm infants in high-resource settings were included. RESULTS: Four randomised clinical trials encompassing 325 infants were included. iSSC was feasible and safe. Cardiorespiratory stability, thermoregulation, breastfeeding practices, maternal-infant interaction, infant stress regulation, and parental mental health outcomes were in favour of the intervention. CONCLUSIONS: This systematic review provides updated evidence on the effectiveness of iSSC for preterm infants admitted to neonatal intensive care units in high resource settings. The findings support that there is a sensitive window in the first hours after birth when preterm infants and parents should not be separated.