Skin-To-Skin Contact for Painful Procedures in Very and Extremely Preterm Infants: A Meta-Analysis and Narrative Synthesis Review

Abstract

Skin-to-skin contact for pain (SSCP) has been recommended as a pain management strategy broadly for infants but no systematic reviews have focused exclusively on the youngest of preterm infants. Thus, the objective of this study was to conduct a meta-analysis and narrative synthesis to examine the effectiveness of SSCP in these infants. Twenty-three studies were included in our review. In our meta-analyses, SSCP showed mixed evidence of significantly reduced pain-related outcomes, but magnitude of the effects varied significantly according to outcome and time point. Our narrative synthesis results suggest SSCP may not provide better pain management than sweet-tasting solutions. Overall, the certainty of the evidence base, using GRADE criteria, ranged from very low to moderate. These findings call for better quality trials. This vulnerable group deserves special attention as the evidence is unclear about the benefits of SSCP, a critical pain management intervention for infants of a higher gestational age.