Thermal stability during early skin-to-skin vs incubator care in infants born at 22–25 weeks’ gestation: a non-inferiority prospective cohort study

Objective Skin-to-skin care (SSC) of extremely preterm infants are often withheld early in life due to the risk of hypothermia. We aimed to evaluate if SSC is non-inferior to incubator care with regard to maintaining normothermia. Study design A non-inferiority study was conducted in infants with a gestational age of 22–25 weeks, during October 2023-January 2026. Axillary temperatures were obtained at three time points; in the incubator, during SSC, and immediately after transfer back to the incubator. Results Body temperature data were obtained from SSC sessions ( n = 125) in the first 2 weeks in 46 eligible infants, among whom 20 were born at 22–23 weeks. In terms of the risk for hypothermia ( < 36.5 °C), SSC was non-inferior to incubator care, and the risk of hypothermia decreased by 5 percentage points ( p < 0.001). Conclusion Infants born at 22–25 weeks can maintain thermoneutrality during SSC if carried out according to a delineated protocol.