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A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.ORCID iD: 0000-0002-3256-5407
Karolinska Institutet.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
2015 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 91, no 1, 63-70 p.Article in journal (Refereed) Published
Abstract [en]


To evaluate the effects of almost continuous skin-to-skin contact (SSC) on salivary cortisol, parental stress, parental depression, and breastfeeding.


This is a randomised study engaging families of late preterm infants (32-35weeks gestation). Salivary cortisol reactivity was measured in infants during a nappy change at one month corrected age, and in infants and mothers during still-face at four month corrected age. Both parents completed the Swedish Parenthood Stress Questionnaire (SPSQ) at one month and the Edinburgh Postnatal Depression Scale (EPDS) at one and four months. Ainsworth's sensitivity scale was used to control for parental sensitivity.


Thirty-seven families from two different neonatal care units in Sweden, randomised to either almost continuous SSC or standard care (SC).


Infants randomised to SSC had a lower salivary cortisol reactivity at one month (p=0.01). There was a correlation between the mothers' and the preterm infants' salivary cortisol levels at four months in the SSC group (ρ=0.65, p=0.005), but not in the SC group (ρ=0.14, p=0.63). Fathers in SSC scored lower on the SPSQ sub-scale spouse relationship problems compared to fathers in SC (p<0.05).


Almost continuous SSC decreases infants' cortisol reactivity in response to handling, improves the concordance between mothers' and infants' salivary cortisol levels, and decreases fathers' experiences of spouse relationship problems.

Place, publisher, year, edition, pages
2015. Vol. 91, no 1, 63-70 p.
Keyword [en]
Cortisol; Kangaroo Mother Care; Neonatal Care; Preterm infants; Stress
National Category
URN: urn:nbn:se:liu:diva-113796DOI: 10.1016/j.earlhumdev.2014.12.005ISI: 000349592600011PubMedID: 25545453OAI: diva2:784698

The authors gratefully acknowledge the participating families, Lisbet de Jounge, Birgitta Lundin, Elisabeth Olhager, and Ihsan Sarman, and staff members at the Neonatal Intensive Care Units at Linkoping University Hospital and at Sachs' Children's Hospital in Stockholm. This study was supported by the County Council of Ostergotland (LiO-12134, LiO-17711, LiO-278801), South Sweden Nursing Society (SSSH-2008), Halsofonden (LiU-2009), and Linkoping University.

Available from: 2015-01-30 Created: 2015-01-30 Last updated: 2016-05-04

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Mörelius, Eva-lottaTheodorsson, ElvarFrostell, Anneli
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Division of Health, Activity and CareFaculty of Health SciencesDepartment of Paediatrics in LinköpingDivision of Microbiology and Molecular MedicineDepartment of Clinical ChemistryPsychologyFaculty of Arts and Sciences
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