Abstract / Summary
Aim: To evaluate the effect of skin-to-skin contact during caesarean section on neonatal pain and stress during the first intramuscular injection.
Design: Prospective randomized controlled trial.
Methods: The study was conducted between January and July 2023 in an education and research hospital. Sixty healthy term newborns of women undergoing elective caesarean delivery under spinal anaesthesia were randomly allocated to skin-to-skin contact (n = 30) or routine care (n = 30). In the intervention group, standardized skin-to-skin contact was provided for approximately 3 min during caesarean section. Neonatal pain and stress were assessed using the Newborn Pain and Stress Assessment Scale (ALPS-Neo) at four predefined timepoints.
Results: ALPS-Neo scores were similar between groups at baseline but were lower in the skin-to-skin contact group immediately before, during, and after the first intramuscular injection. During the injection, the mean between-group difference was -2.633 (95% CI: -3.135 to -2.132, p < 0.001), with a large standardized effect (Hedges' g = -2.68, 95% CI: -3.38 to -1.99).
Conclusion: Brief intraoperative skin-to-skin contact may reduce immediate neonatal pain and stress during the first intramuscular injection after caesarean birth.
Implications for the profession and/or patient care: Skin-to-skin contact may provide a simple non-pharmacological strategy to support neonatal comfort during routine painful procedures after caesarean birth when appropriate clinical and thermal conditions are ensured.
Impact: This study supports the analgesic and stress-reducing effects of skin-to-skin contact and extends existing evidence to brief intraoperative contact during caesarean delivery. Repeated assessment showed that the between-group difference was greatest during the painful procedure.
Reporting method: The study was reported in accordance with the CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments.
No patient or public contribution: There was no patient or public involvement in the design, management, interpretation, reporting, or dissemination of this study. Women and their newborns were involved solely as research participants, and written informed consent was obtained from the women before participation.
Trial and protocol registration: ClinicalTrials.gov (registration number: NCT05700552).