Tempo de contato pele-a-pele intra-hospitalar e amamentação de recém-nascidos pré-termo

Abstract

Introduction: Skin-to-skin contact (SSC) is considered an effective, low-cost and safe strategy, with positive effects already well defined in the literature for newborns. However, there is still a lack of knowledge about what would be the SSC time during hospitalization that could favor breastfeeding in the short and medium term. Objective: To evaluate the association between the time of SSC in preterm infants during hospitalization and maintenance of breastfeeding at four months of corrected age. Method: This is a prospective cohort study carried out in three Brazilian public institutions with 184 preterm infants and low birth weight (until 1800g) borned between January 2018 and March 2020, excluding those with comorbidities. During hospitalization, maternal variables (age, parity, number of prenatal consultations and type of birth), neonatal variables (weight at birth and discharge, gestational age at birth and diet at discharge) and variables related to SSC (total time per day performed, time per day performed at the Neonatal Intensive Care Unit, Conventional Neonatal Intermediate Care Unit and Kangaroo Neonatal Intermediate Care Unit/UCINCa). At the outpatient follow-up visit, data referring to the offered diet and weight at four months of corrected age were collected from hospital records. For the analysis of the variables that influenced breastfeeding at four months of corrected age, the Classification and Regression Tree method based on artificial intelligence was used associated with the Chi-squared Automatic Interaction Detection (CHAID) method with SPSS 26.0 software. Results: The median birth weight of the 184 preterm infants included was 1390g and the gestational age at birth ranged from 23.5 to 36.5 weeks. Preterm infants who spent more than 155 minutes a day on SSC during hospitalization were more likely to remain on breastfeeding after four months of IGC (47.8% vs. 68.5%, p=0.041). Conclusions: The time of exposure to SSC during hospitalization was strongly associated with the permanence of breastfeeding at four months of corrected age for low birth weight preterm infants.