Impact of skin-to-skin contact during postnatal transport in a low-resource setting: a prospective, observational study in Mozambique

Postnatal transport may exacerbate thermal loss in low-resource settings. This study investigated the impact of skin-to-skin contact (SSC) on temperature, heart rate and oxygen saturation during postnatal transport in a low-resource setting. This is a prospective, observational study on SSC during postnatal transport by ambulance to Beira Central Hospital (Mozambique) between July and November 2024. Neonates were usually transferred in parents’ arms and SSC was offered to the parents. The outcome measures were neonatal temperature, normothermia, heart rate and oxygen saturation at admission. In 238 neonates, mean travel time was 18 min (SD 10) and SSC was performed in 30.7% of cases. At arrival, mean temperature was 35.9 °C (SD 1.3) with a normothermia rate of 27.3%. Adjusting for clinically relevant confounders, SSC was not associated with admission temperature (MD 0.19 °C, 95% CI -0.12 to 0.49 °C) or normothermia (OR 0.98, 95% CI 0.87 to 1.11). Adjusting for clinically relevant confounders, SSC was not associated with heart rate (MD 2.13 bpm, 95% CI -3.76 to 8.03 bpm) or oxygen saturation (MD 0.30, 95% CI -3.15 to 3.75) at admission. Compared to being carried in parent’s arms, SSC was not associated to improved thermal control, heart rate and oxygenation stability in newborns needing postnatal transport in a low-resource setting under the condition studied. Future investigations may explore the role of SSC in longer postnatal transports and further efforts should focus on improving neonatal thermal care in peripheral health facilities and during postnatal transport.