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Am J Perinatol
DOI: 10.1055/a-2526-5064
Original Article

The Skincubator: A Novel Incubator for Skin-to-Skin Care (SSC) of Premature Neonates, Enables SSC within Humidified Environment and may Improve Thermoregulation during SSC

Itamar Nitzan 
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
2   Department of Pediatrics, The Hebrew University of Jerusalem, Jerusalem, Israel
,
Yair Kasirer
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
2   Department of Pediatrics, The Hebrew University of Jerusalem, Jerusalem, Israel
,
Francis B. Mimouni
3   Leumit Health Services, Tel Aviv, Israel
4   Department of Pediatrics, The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel
,
Tehilla Kagan
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Alona Bin Nun
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
2   Department of Pediatrics, The Hebrew University of Jerusalem, Jerusalem, Israel
,
Tali B. Weiss
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Robert D. White
5   Beacon Children's Hospital, South Bend, Indiana
,
Cathy Hammerman 
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
2   Department of Pediatrics, The Hebrew University of Jerusalem, Jerusalem, Israel
› Author Affiliations
Funding The study was supported by the Shaare Zedek Medical Center and by the Thrasher Fund Early Career Award.
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Abstract

Objective This study aimed to assess thermoregulation and humidity within the Skincubator—a novel, wearable skin-to-skin incubator designed to attach to the caregiver.

Study Design Preterm neonates (PN; born between 24 and 33 weeks gestational age [GA]) received skin-to-skin care (SSC) either via the Skincubator or traditional SSC (t-SSC) with continuous axillary temperature monitoring.

Results Twenty PN were enrolled in the study and treated in the Skincubator. One couple who consented to Skincubator care during delivery subsequently revoked their consent and the baby was excluded from further analysis. Fifty-four paired sessions of Skincubator and t-SCC were performed and compared for 19 babies. The average GA was 29 weeks (range: 26–32), the average weight was −1,296 ± 271 g, and the average day of life was 5 ± 2. The temperature drop after transfer to Skincubator care was smaller than in t-SSC (0.2°C [0.2–0.3] vs. 0.4°C [0.3–0.6]; Wilcoxon's signed rank test [WSRT], p < 0.001). The average hypothermia time per session was a median (25th–75th%) of 8.2 minutes (0–9) for Skincubator, compared to 27.8 minutes (0–56) for t-SSC, respectively (WSRT, p = 0.002). No baby had moderate hypothermia (35.5–35.9°C) during Skincubator care as compared with eight babies who experienced moderate hypothermia during t-SSC (Fisher's exact test p = 0.003). The average Skincubator humidity was 85 ± 7% and was above 70% during 93% of the time.

Conclusion Skincubator SSC was superior to t-SSC in maintaining PN temperature while also maintaining an optimally humidified environment. The Skincubator may promote early SSC in very and extremely PN. (Trial registration number MOH_2021–12–13_010470 registration date 24/10/21.)

Key Points

  • Early prolonged SSC improves preterm infants' outcomes but may be challenging to perform.

  • To mitigate several SSC barriers we invented the Skincubator, a wearable incubator for SSC.

  • We have shown that the Skincubator reduces transient moderate hypothermia at SSC initiation.

  • Average Skincubator humidity was 85 ± 7% and above 70% during 93% of SSC time.

Keywords

skin-to-skin care - kangaroo mother care - preterm neonates - thermoregulation

Authors' Contributions

I.N. conceived the trial recruited the patients supported the nurses and drafted the article. Y.K. performed statistical analysis and critically reviewed the article. F.B.M. helped in conceiving the study and critically reviewed the manuscript. T.K. helped in conceiving the study and writing the nursing protocol for treatment in the Skincubator. A.B.N. helped in conceiving the study overlooked and supported the study performance and critically reviewed the manuscript. T.B.W. helped in conceiving the study writing nursing protocol of treatment in the Skincubator. R.D.W. critically reviewed the manuscript and contributed significantly to the introduction and discussion. C.H. helped in conceiving the study overlooked and supported the study performance and critically reviewed the manuscript.




Publication History

Received: 26 November 2024

Accepted: 27 January 2025

Accepted Manuscript online:
31 January 2025

Article published online:
14 February 2025

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