Prospektive Kohortenstudie über den Zusammenhang zwischen frühem Hautkontakt zwischen Mutter und Kind nach primärer Sectio und der Stilldauer des vollen Stillens sowie dem Auftreten einer atopischen Dermatitis innerhalb der ersten 12 Lebensmonate
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Philipps-Universität Marburg
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Abstract
Background: Present efforts promote breastfeeding in clinics in Germany have
not yet gained widespread acceptance despite recommendations to promote
early skin-to-skin contact within clinic routines. The development of atopic allergic
diseases is complex and is currently being studied from different research angles.
In theory, the role of the first early skin-to-skin contact after elective cesarean
section on the development of atopic allergic disease has not been considered,
a deficiency that is addressed in this work. For the present study, early skin contact
means: The dry newborn is placed naked with the side of the abdomen on
the mother's bare chest or abdomen within the first half hour of life.
Objective: Against this background, the primary aim of this study was to answer
the association of early skin contact on breastfeeding duration until the 6th month
of life. And to answer the research question about the association between the
first early skin-to-skin contact and the development of atopic dermatitis during the
first 12 months of life. In addition, association studies were used to identify various
factors influencing the length of breastfeeding and the development of atopic
dermatitis in connection with the first early skin-to-skin contact.
Design and Methods: The present study was conducted as a bi-center prospective
cohort study with a 15-month recruitment period. Recruitment took place in
2 university hospitals in Germany. Data from 198 mother-infant pairs were included
in the study. The study population consisted of mothers >18 years of age,
at >37th + 0th gestational age, who were delivered by primary section. Data were
collected prospectively at 5 measurement time points using a telephone interview
guide with a follow-up of 12 months. The follow-up rate was 87.87% at 12 months
of life.
Results: Major findings were when the first skin-to-skin contact occurs and when
skin-to-skin contact was for more than one hour, the longer mothers breastfeed
their infants. In the hospital, more mothers breastfeed when skin-to-skin contact
is allowed and performed. Furthermore, infant feeding with breast milk is favored
when skin-to-skin contact is occurred. The sooner mothers initially start breastfeeding
their newborns after birth, the longer they breastfeed. If intubation anesthesia
was used or mother and baby were separated, breastfeeding duration is
shortened. And if the mother smokes or takes medication, she stops breastfeeding
earlier. Regarding atopic diseases, it was found that skin-to-skin contact has
neither a positive nor a negative effect on the development of atopic-allergic diseases.
Breastfeeding and how long the mother breastfeeds her infant also has
no influence on the development of atopic-allergic diseases.
Conclusion: Clinical practice proved to be insufficient in terms of providing early
skin-to-skin contact. To support bonding and the early breastfeeding, it is recommended
to implement a holistic model of care for pre-, peri- and postoperative
management. No disadvantages were found between the first early skin-to-skin
contact and the development of atopic-allergic diseases. Nevertheless, because
of the benefits of first early skin-to-skin contact and breastfeeding, it is generally
recommended to breastfeed until the beginning of the 6th month of life. The current
scientific knowledge related to skin-to-skin contact and the development of
atopic-allergic diseases should be expanded and deepened. For example, there
is the possibility of a study over a longer period, with the participants needed for
this already being available. Further studies on the composition of breast milk or
on the development of the microbiome, which are associated with the occurrence
of atopy, could follow to deepen the knowledge of the problem under investigation.
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Dates
Created: 2023Issued: 2023-11-20Updated: 2023-11-20
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
KaiserschnittStillenatopische Dermatitisatopisch-allergische Erkrankungensectio caesareaStilldauererster früher Hautkontakt
DDC-Numbers
610
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Stephan, Yvonne (0009-0004-5396-314X): Prospektive Kohortenstudie über den Zusammenhang zwischen frühem Hautkontakt zwischen Mutter und Kind nach primärer Sectio und der Stilldauer des vollen Stillens sowie dem Auftreten einer atopischen Dermatitis innerhalb der ersten 12 Lebensmonate. : Philipps-Universität Marburg 2023-11-20. DOI: https://doi.org/10.17192/z2023.0597.
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This item has been published with the following license: In Copyright