Immediate skin-to-skin contact at very preterm birth and effect on infant socio-emotional stress response and mother–infant cortisol co-regulation : secondary outcomes from the randomised clinical Immediate Parent-Infant Skin-To-Skin Study (IPISTOSS)

Lode-Kolz, Karoline; Lillieskold, Siri; Hetland, Hanne Brit; Mascheroni, Eleonora; Klemming, Stina; Pike, Hanne; Linner, Agnes; Bergman, Nils J.; Westrup, Bjorn; Ådén, Ulrika; Morelius, Evalotte; Montirosso, Rosario; Jonas, Wibke; Rettedal, Siren

Immediate skin-to-skin contact at very preterm birth and effect on infant socio-emotional stress response and mother–infant cortisol co-regulation : secondary outcomes from the randomised clinical Immediate Parent-Infant Skin-To-Skin Study (IPISTOSS)

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Lode-Kolz, Karoline ; Lillieskold, Siri ; Hetland, Hanne Brit ; Mascheroni, Eleonora ; Klemming, Stina ; Pike, Hanne ; Linner, Agnes ; Bergman, Nils J. ; Westrup, Bjorn and Ådén, Ulrika ^LU , et al. (2026) In BMJ Paediatrics Open 10(1).

Abstract: Objective To explore the effects of immediate parent–infant skin-to-skin contact (iSSC) at very preterm birth on maternal–infant behavioural responses and hypothalamic–pituitary–adrenal (HPA) axis reactivity to age-appropriate socio-emotional stress at 4months corrected age. Design Two secondary outcomes from a multicentre randomised controlled trial with two non-blinded parallel groups. Setting Three Scandinavian neonatal intensive care units, level 2 and level 3. Participants 91 infants born at gestational age 28+0to 32+6 from April 2018 to June 2021. Singletons and twins with a second caregiver present were included, regardless of mode of birth. Higher-order births, infants with congenital infections and major malformations were... (More); Objective To explore the effects of immediate parent–infant skin-to-skin contact (iSSC) at very preterm birth on maternal–infant behavioural responses and hypothalamic–pituitary–adrenal (HPA) axis reactivity to age-appropriate socio-emotional stress at 4months corrected age. Design Two secondary outcomes from a multicentre randomised controlled trial with two non-blinded parallel groups. Setting Three Scandinavian neonatal intensive care units, level 2 and level 3. Participants 91 infants born at gestational age 28+0to 32+6 from April 2018 to June 2021. Singletons and twins with a second caregiver present were included, regardless of mode of birth. Higher-order births, infants with congenital infections and major malformations were excluded. Intervention Infants were randomised before birth to iSSC (n=46) or conventional care (n=45) during the first 6hours of life. At 4months corrected age, the infants were exposed to socio-emotional stress using the Face-to-Face Still-Face procedure (FFSF). Salivary cortisol was collected before and after FFSF. Main outcome measures Behavioural and hormonal stress responses at 4 months of age. Results 65 of 91 infants were assessed by FFSF, of which 37 infants had cortisol sampling. The iSSC group demonstrated heightened positive emotionality during FFSF compared with controls (beta 0.74, 95%CI 0.40 to 1.07; p<0.001). Also, the iSSC group showed an association between mother−infant cortisol levels at baseline (r 0.55, 95%CI 0.13 to 0.80; p=0.014) and 30min post-FFSF (r 0.55, 95%CI 0.05 to 0.83; p=0.035). Conclusion Infants who experienced iSSC during the first 6hours after very preterm birth showed improved infant socio-emotional stress coping and suggested enhanced mother–infant HPA axis synchrony at 4months.
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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/47971b16-6304-47c6-8b47-bb2c94676701

author

Lode-Kolz, Karoline ; Lillieskold, Siri ; Hetland, Hanne Brit ; Mascheroni, Eleonora ; Klemming, Stina ; Pike, Hanne ; Linner, Agnes ; Bergman, Nils J. ; Westrup, Bjorn and Ådén, Ulrika ^LU , et al. (More)

Lode-Kolz, Karoline ; Lillieskold, Siri ; Hetland, Hanne Brit ; Mascheroni, Eleonora ; Klemming, Stina ; Pike, Hanne ; Linner, Agnes ; Bergman, Nils J. ; Westrup, Bjorn ; Ådén, Ulrika ^LU ; Morelius, Evalotte ; Montirosso, Rosario ; Jonas, Wibke and Rettedal, Siren (Less)

organization

Tornblad Institute (research group)

publishing date

2026-02-11

type

Contribution to journal

publication status

published

subject

Pediatrics

keywords

Endocrinology, Intensive Care Units, Neonatal, Neonatology, Psychology

in

BMJ Paediatrics Open

volume

10

issue

1

article number

e003778

publisher

BMJ Publishing Group

external identifiers

scopus:105030963091
pmid:41672603

ISSN

2399-9772

DOI

10.1136/bmjpo-2025-003778

language

English

LU publication?

yes

additional info

id

47971b16-6304-47c6-8b47-bb2c94676701

date added to LUP

2026-04-13 12:27:17

date last changed

2026-05-25 16:54:39

@article{47971b16-6304-47c6-8b47-bb2c94676701,
  abstract     = {{<p>Objective To explore the effects of immediate parent–infant skin-to-skin contact (iSSC) at very preterm birth on maternal–infant behavioural responses and hypothalamic–pituitary–adrenal (HPA) axis reactivity to age-appropriate socio-emotional stress at 4months corrected age. Design Two secondary outcomes from a multicentre randomised controlled trial with two non-blinded parallel groups. Setting Three Scandinavian neonatal intensive care units, level 2 and level 3. Participants 91 infants born at gestational age 28+0to 32+6 from April 2018 to June 2021. Singletons and twins with a second caregiver present were included, regardless of mode of birth. Higher-order births, infants with congenital infections and major malformations were excluded. Intervention Infants were randomised before birth to iSSC (n=46) or conventional care (n=45) during the first 6hours of life. At 4months corrected age, the infants were exposed to socio-emotional stress using the Face-to-Face Still-Face procedure (FFSF). Salivary cortisol was collected before and after FFSF. Main outcome measures Behavioural and hormonal stress responses at 4 months of age. Results 65 of 91 infants were assessed by FFSF, of which 37 infants had cortisol sampling. The iSSC group demonstrated heightened positive emotionality during FFSF compared with controls (beta 0.74, 95%CI 0.40 to 1.07; p&lt;0.001). Also, the iSSC group showed an association between mother−infant cortisol levels at baseline (r 0.55, 95%CI 0.13 to 0.80; p=0.014) and 30min post-FFSF (r 0.55, 95%CI 0.05 to 0.83; p=0.035). Conclusion Infants who experienced iSSC during the first 6hours after very preterm birth showed improved infant socio-emotional stress coping and suggested enhanced mother–infant HPA axis synchrony at 4months.</p>}},
  author       = {{Lode-Kolz, Karoline and Lillieskold, Siri and Hetland, Hanne Brit and Mascheroni, Eleonora and Klemming, Stina and Pike, Hanne and Linner, Agnes and Bergman, Nils J. and Westrup, Bjorn and Ådén, Ulrika and Morelius, Evalotte and Montirosso, Rosario and Jonas, Wibke and Rettedal, Siren}},
  issn         = {{2399-9772}},
  keywords     = {{Endocrinology; Intensive Care Units, Neonatal; Neonatology; Psychology}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{1}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Paediatrics Open}},
  title        = {{Immediate skin-to-skin contact at very preterm birth and effect on infant socio-emotional stress response and mother–infant cortisol co-regulation : secondary outcomes from the randomised clinical Immediate Parent-Infant Skin-To-Skin Study (IPISTOSS)}},
  url          = {{http://dx.doi.org/10.1136/bmjpo-2025-003778}},
  doi          = {{10.1136/bmjpo-2025-003778}},
  volume       = {{10}},
  year         = {{2026}},
}

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Immediate skin-to-skin contact at very preterm birth and effect on infant socio-emotional stress response and mother–infant cortisol co-regulation : secondary outcomes from the randomised clinical Immediate Parent-Infant Skin-To-Skin Study (IPISTOSS)