Parent–Infant Skin-to-Skin Contact and Stress Regulation: A Systematic Review of the Literature
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Heart Rate Variability
3.2. Maternal Stress
3.3. Cortisol
3.4. Oxytocin
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | Scope of the Study | Participants | Findings | Physiological Outcomes |
---|---|---|---|---|
Butruille, 2017 [36] | Influence of skin-to-skin contact (SSC) on the parasympathetic activity evaluated by heart rate variability (HRV) | Twenty-two infants and their mothers | SSC had a favourable impact on maternal and premature infant parasympathetic activities with a pronounced neonate response when baseline HRV values were lower | HRV |
Carozza, 2020 [37] | Brief review of how contact influences the development of infant somatosensory, autonomic, and immune systems | Contact is an essential pathway for establishing and maintaining behavioural, physiological, and neural levels of parent–child interaction synchrony | Stress | |
Cho, 2016 [38] | Explore the effects of kangaroo care (KC) on physiological functions of preterm infants and maternal stress. | Twenty infants were assigned to the experimental group and 20 to the control group | KC had positive effects on stabilizing infant physiological functions such as respiration rate and reducing maternal stress. | HRV and maternal stress |
Cleveland, 2017 [39] | Explain the effect of SSC on full-term newborns | Recommendations of SSC for healthy newborns | ||
Cong, 2015 [40] | Investigate how oxytocin modulates parental stress and anxiety during maternal and paternal SSC | Twenty-eight stable preterm infants and their parents | Both maternal and paternal oxytocin levels were significantly increased from baseline during the SSC. Both maternal and paternal cortisol levels decreased significantly from baseline during SSC. | Oxytocin and cortisol |
Coskun, 2019 [41] | Investigate the effects of KC on the mother’s stress and amount of milk production | Eighty-four preterm newborns and their mothers | KC is effective in stimulating breast milk production and lowering maternal stress levels. | Maternal stress |
El Farrash, 2019 [42] | Assess the effect of KC and its duration on the neurobehavioral system and salivary cortisol | One hundred and twenty stable preterm neonates | KC improved higher scores for regulation, non-optimal reflexes, and movement quality and lower scores for handling, excitement, and cortisol compared with the control group | Cortisol |
Hardin, 2020 [43] | Examine EEG patterns along with basal oxytocin and cortisol reactivity in infants related to KC | Thirty-three mother–infant dyads at neonatal and three-month periods | KC increased oxytocin levels and decreased cortisol reactivity. | Oxytocin and cortisol |
Harrison, 2017 [44] | Examine SSC’s effects on autonomic nervous system (ANS) functions | Eighteen infants and their mothers | HRV measures suggested improvements to the ANS functions after SSC | HRV |
Harrison, 2019 [45] | Investigate the effects of SSC on learning and autonomic functions in three-month-old infants | Ten infants with congenital heart disease (CHD) who received neonatal SSC, 16 typically developing (TD) infants, and 10 infants with CCHD without SSC | The findings suggest improvements in cognitive and autonomic development in three-month-old CCHD infants who received neonatal SSC. | HRV |
Jones et al. 2017 [46] | Explore the effect of SSC between parents and their neonates on parents’ heart rate (HR) | Twenty-six parents and their babies | A statistically significant difference between the parents’ initial HR and HR after SSC | HRV |
Kommers, 2017 [47] | Explore whether HRV could be a measure to track regulatory changes during KC | Eleven preterm infants | A statistically significant difference in HRV between periods of KC and pre-KC | HRV |
Kommers, 2018 [48] | Explore if a mattress that mimics breathing motion and heartbeat sounds can have the same effects as KC in preterm infants, as measured by HRV | Twenty preterm infants | HRV decreased during KC and after KC. No non-mattress effects were reported. | HRV |
Kommers, 2018 [49] | Explore whether KC influences the salivary oxytocin concentration in preterm infants | Eleven twin pairs | Preterm infant twins’ oxytocin concentrations decreased during KC | Oxytocin |
Kommers et al., 2019 [50] | Vital signs and HRV were analysed during KC with and without the use of a swaddling device to identify any potential changes | Twenty preterm infants | KC decreased heart rate, respiratory rate, and HRV. No changes were found regarding the swaddling device | HRV |
Lisanti, 2020 [51] | Estimate SSC’s effect on mothers’ bio-behavioural stress measures (anxiety and salivary cortisol) before and after neonatal cardiac surgery | Thirty women and their infants | Significant reductions in self-reported anxiety and salivary cortisol scores were identified as a result of SSC. | Cortisol, HRV |
Mirnia et al., 2017 [52] | Investigate the effect of SSC by fathers on salivary cortisol of infants | Forty-five premature infants and their fathers | SSC decreased levels of cortisol in babies. | Cortisol |
Moberg, 2020 [53] | Describe the oxytocinergic system and the cutaneous sensory pathways activated by SSC | Decreased stress levels could be considered due to oxytocin’s ability to reduce the amygdala’s activity, the HPA-axis, and the sympathetic nervous system. | Oxytocin | |
Morelius, 2015 [54] | Investigate the effects of SSC on salivary cortisol, parental stress, depression, and breastfeeding | Thirty-seven families | SSC reduces infant cortisol reactivity in response to treatment and improves concordance between mother and infant salivary cortisol levels. | Cortisol and parental stress |
Pados, 2019 [26] | Describe the physiological stress mechanisms that contribute to infant mortality and morbidity in the NICU and the physiological mechanisms by which SSC acts on the stress response system | Importance of SSC to mother–infant stress regulation | Stress | |
Pados et al., 2020 [55] | Investigate if SSC is an intervention used to reduce stress in the NICU | Research supports that SSC improves short-term cardiorespiratory stress outcomes compared with incubator care. | Stress, cortisol HRV, oxytocin | |
Varela, 2017 [56] | Explore paternal physiological stress during SSC with their babies | Forty-nine fathers | Fathers who practiced SSC showed a significant reduction in physiological stress outcomes. | Cortisol |
Vitnner, 2018 [57] | Examine the relationship between parental involvement and salivary oxytocin and cortisol levels for parents participating in SSC intervention | Thirty-two stable preterm infants and their mothers and fathers | Significant relationships exist between parental engagement and salivary oxytocin and cortisol levels. | Oxytocin and cortisol |
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Ionio, C.; Ciuffo, G.; Landoni, M. Parent–Infant Skin-to-Skin Contact and Stress Regulation: A Systematic Review of the Literature. Int. J. Environ. Res. Public Health 2021, 18, 4695. https://doi.org/10.3390/ijerph18094695
Ionio C, Ciuffo G, Landoni M. Parent–Infant Skin-to-Skin Contact and Stress Regulation: A Systematic Review of the Literature. International Journal of Environmental Research and Public Health. 2021; 18(9):4695. https://doi.org/10.3390/ijerph18094695
Chicago/Turabian StyleIonio, Chiara, Giulia Ciuffo, and Marta Landoni. 2021. "Parent–Infant Skin-to-Skin Contact and Stress Regulation: A Systematic Review of the Literature" International Journal of Environmental Research and Public Health 18, no. 9: 4695. https://doi.org/10.3390/ijerph18094695