AUTHOR=Buil Aude , Sankey Carol , Caeymaex Laurence , Gratier Maya , Apter Gisèle , Vitte Lisa , Devouche Emmanuel 

TITLE=Skin-to-skin SDF positioning: The key to intersubjective intimacy between mother and very preterm newborn—A pilot matched-pair case-control study

JOURNAL=Frontiers in Psychology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2022.790313

DOI=10.3389/fpsyg.2022.790313

ISSN=1664-1078

ABSTRACT=Background. Skin-to-skin contact (SSC) has been widely studied in NICU and several meta-analyses have looked at its benefits, for both the baby and the parent. However, very few studies have investigated SSC’ benefits for communication, in particular in the very-preterm newborn immediately after birth. 
Aims. To investigate the immediate benefits of Supported Diagonal Flexion (SDF) positioning during SSC on the quality of mother - very-preterm newborn communication and to examine the coordination of the timing of communicative behaviours, just a few days after birth.
Subjects and Study design. Monocentric prospective matched-pair case-control study. Thirty-four mothers and their very preterm infants (27 to 31+6 weeks GA; mean age at birth: 30 weeks GA) were assigned to one of the two SSC positions, either the Vertical Control (n = 17) or the SDF Intervention positioning (n = 17). Mother and newborn were filmed during the first 5 minutes of their first SSC.
Outcome measures. Infants’ states of consciousness according to the Assessment of Preterm Infants’ Behavior scale (APIB). Onset and duration of newborns’ and mothers’ vocalisations and their temporal proximity within a 1-sec time-window. 
Results. In comparison with the Vertical group, very preterm newborns in the SDF Intervention Group spent less time in a drowsy state and more in deep sleep. At 3.5 days of life, newborns’ vocal production in SSC did not differ significantly between the two groups. Mothers offered a denser vocal envelope in the SDF group than in the Vertical group and their vocalisations were on average significantly longer. Moreover, in a one-second time-frame, temporal proximity of mother-very preterm newborn behaviours was greater in the SDF Intervention Group.
Conclusion. Although conducted on a limited number of dyads, our study shows that SDF positioning fosters mother-very preterm newborn intimate encounter during the very first skin to skin contact after delivery. Our pioneer data sheds light on the way a mother and her very preterm vocally meet, and constitutes a pilot step in the exploration of innate intersubjectivity in the context of very preterm birth.