title: Skin-to-skin contact with an umbilical venous catheter: prospective evaluation in a level 3 unit.
abstract: The aim was to assess the incidence of complications related to skin-to-skin contact (SSC) in newborns with an umbilical venous catheter (UVC). We carried out a prospective follow-up study of all UVCs in a level 3 unit where SSC is systematic. A total of 333 babies were included (mean gestational age of 31.3 weeks (24-41), mean birth weight of 1618 g (454-4900). Two hundred sixty-three babies (78.9 %) had SSC, at a mean postnatal age of 24 h (3-144 h). Two babies presented with a significant umbilical bleeding, all in the first 3 h, before SSC. In 17 cases of UVC leaking, this necessitated an unwanted withdrawal of the UVC; of these, 14 UVCs (82 %) were in sub-hepatic position. In five cases of UVC displacement, babies had no SSC. The overall incidence (3 % [95 % CI = 1.4-5.4]) and incidence density (6.2/1000 UVC-day [95 % CI = 3-11.4]) of catheter-associated infections are similar to those identified by the French multicenter network NEOCAT in 2012 (5 % [95 % CI = 4.1-5.9] and 11.3/1000 UVC-day [95 % CI = 9.3-13.2]).
  
  
  CONCLUSIONS
  In this prospective, non-randomized study in a level unit, routine practice of SSC with a UVC does not seem to influence the incidence of mechanical and infectious complications. What is known? • SSC is beneficial for pretem infants. • Fear of mechanical problems and/or infections with a UVC is an obstacle to early use of SSC. What is New: • In this study, SSC for preterm infants with a UVC is associated with low risks of mechanical complications, and does not seem to be associated with any higher risk of catheter-related infections.
authors.affiliation: Service de Néonatologie, Centre Hospitalier, 59300, Valenciennes, France. zaoui-c@ch-valenciennes.fr.
authors.forename: Zaoui-Grattepanche
authors.initials: ZG
authors.lastname: Catherine
authors.affiliation: Service de Néonatologie, Centre Hospitalier, 59300, Valenciennes, France.
authors.forename: Pindi
authors.initials: P
authors.lastname: Béatrice
authors.affiliation: Service de Néonatologie, Centre Hospitalier, 59300, Valenciennes, France.
authors.forename: Lapeyre
authors.initials: L
authors.lastname: Fabrice
authors.affiliation: Unité de Lutte contre Les Infections nosocomiales, Centre Hospitalier, 59300, Valenciennes, France.
authors.forename: Huart
authors.initials: H
authors.lastname: Claire
authors.affiliation: Department of biostatistics EA 2694, University of Lille, CHRU Lille, Lille, France.
authors.forename: Duhamel
authors.initials: D
authors.lastname: Alain
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012867:Skin; D014471:Umbilical Veins / Q000601:surgery*
keywords: Catheter-associated bloodstream infection; Kangaroo Mother Care; Skin to skin contact; Umbilical venous catheter