Outcomes | Subgroups | No. of participants (studies) | Relative risk (RR) or mean difference (MD) (95% CI) | P for overall effect | I2 | P for subgroup interaction |
---|---|---|---|---|---|---|
Duration of skin-to-skin contact | ||||||
 Neonatal hypoglycaemia |  < 60 min | 308 (2) | 0.46 (0.08, 2.55) | 0.37 | 70% | 0.68 |
 ≥ 60 min | 514 (4) | 0.29 (0.08, 1.10) | 0.07 | 52% | ||
 Admission to special care nursery or neonatal intensive care |  < 60 min | 191 (1) | 5.24 (0.64, 42.66) | 0.12 | N/A | 0.08 |
 ≥ 60 min | 482 (3) | 0.74 (0.45, 1.60) | 0.34 | 54% | ||
 Hypothermia |  < 60 min | 625 (5) | 1.16 (0.82, 1.64) | 0.39 | 22% | 0.0005 |
 ≥ 60 min | 1951 (16) | 0.34 (0.18, 0.62) | 0.0003 | 83% | ||
 Hyperthermia |  < 60 min | 197 (2) | 0.80 (0.26, 2.42) | 0.69 | 0% | 0.76 |
 ≥ 60 min | 572 (6) | 0.66 (0.51, 0.86) | 0.002 | 0% | ||
 Exclusive breastmilk feeding at discharge |  < 60 min | 271 (2) | 1.25 [0.97, 1.62] | 0.08 | 0% | 0.95 |
 ≥ 60 min | 893 (6) | 1.27 [0.94, 1.71] | 0.12 | 95% | ||
 Exclusive breastmilk feeding within the period from discharge to 3 months |  < 60 min | 199 (1) | 1.25 [1.02, 1.54] | 0.04 | N/A | 0.32 |
 ≥ 60 min | 970 (10) | 1.44 [1.19, 1.74] | 0.0001 | 63% | ||
 Any breastmilk feeding at discharge |  < 60 min | 29 (1) | 1.07 [0.89, 1.28] | 0.47 | N/A | 0.07 |
 ≥ 60 min | 156 (2) | 1.24 [0.43, 3.55] | 0.07 | 84% | ||
 Blood glucose concentration |  < 60 min | 117 (1) | 0.52 [0.20, 0.84] | 0.001 | N/A | 0.33 |
 ≥ 60 min | 211 (4) | 0.25 [-0.18, 0.69] | 0.26 | 56% | ||
Timing of initiation of skin-to-skin contact | ||||||
 Neonatal hypoglycaemia | Immediate ≤ 10 min | 408 (3) | 0.40 (0.11, 1.43) | 0.16 | 42% | 0.05 |
Early > 10 min to 24 h | 108 (1) | 5.58 (0.27 – 113.50) | 0.26 | N/A | ||
 > 24 h to discharge | 406 (3) | 0.15 (0.07, 0.34) |  < 0.0001 | 0% | ||
 Hypothermia | Immediate ≤ 10 min | 1488 (11) | 0.67 (0.35, 1.31) | 0.25 | 85% | 0.02 |
Early > 10 min to 24 h | 557 (4) | 0.63 (0.31, 1.28) | 0.20 | 64% | ||
 > 24 h to discharge | 588 (6) | 0.25 (0.16, 0.40) |  < 0.0001 | 0% | ||
 Hyperthermia | Immediate ≤ 10 min | 208 (2) | 0.71 (0.51, 1.01) | 0.05 | 0% | 0.70 |
Early > 10 min to 24 h | 188 (2) | 0.56 (0.34, 0.92) | 0.02 | 0% | ||
 > 24 h to discharge | 373 (4) | 0.71 (0.41, 1.24) | 0.23 | 0% | ||
 Duration of hospital stays (days) | Immediate ≤ 10 min | 100 (1) | -1.50 (-3.26, 0.26) | 0.09 | N/A | 0.20 |
Early > 10 min to 24 h | 301 (2) | 0.19 (-2.56, 2.94) | 0.89 | 0% | ||
 > 24 h to discharge | 2386 (19) | -2.70 [-4.36, -1.03] | 0.002 | 93% | ||
 Exclusive breastmilk feeding at discharge | Immediate ≤ 10 min | 553 (4) | 1.15 (1.02, 1.30) | 0.02 | 12% | 0.62 |
Early > 10 min to 24 h | 449 (4) | 1.16 (078, 1.72) | 0.48 | 93% | ||
 > 24 h to discharge | 279 (1) | 1.25 [1.10, 1.42] | 0.0005 | N/A | ||
 Exclusive breastmilk feeding within the period from discharge to 3 months | Immediate ≤ 10 min | 671 (5) | 1.21 [0.98, 1.49] | 0.07 | 52% | 0.43 |
Early > 10 min to 24 h | 417 (4) | 1.38 [1.21, 1.58] |  < 0.0001 | 0% | ||
 > 24 h to discharge | 823 (3) | 1.23 [1.04, 1.45] | 0.01 | 0% | ||
 Exclusive breastmilk feeding within the period from 3 to 6 months | Immediate ≤ 10 min | 66 (1) | 2.51 [0.11, 59.53] | 0.57 | N/A | 0.62 |
Early > 10 min to 24 h | 26 (1) | 1.07 [0.37, 3.11] | 0.90 | N/A | ||
 > 24 h to discharge | 0 | - | - | - | ||
 Any breastmilk feeding at discharge | Immediate ≤ 10 min | 0 | - | - | - | 0.77 |
Early > 10 min to 24 h | 29 (1) | 1.07 [0.89, 1.28] | 0.47 | N/A | ||
 > 24 h to discharge | 30 (1) | 1.23 [0.50, 3.00] | 0.66 | N/A | ||
 Blood glucose concentration | Immediate ≤ 10 min | 267 (3) | 0.58 [0.36, 0.81] |  < 0.0001 | 0% | 0.03 |
Early > 10 min to 24 h | 44 (1) | 0.00 [-0.40, 0.40] | 1.00 | N/A | ||
 > 24 h to discharge | 117 (2) | 0.09 [-0.86, 1.05] | 0.85 | 51% | ||
Babies born preterm versus at term | ||||||
 Neonatal hypoglycaemia | Preterm | 248 (2) | 1.41 (0.09, 22.99) | 0.81 | 38% | 0.90 |
Term | 191 (1) | 1.16 (0.27, 5.06) | 0.84 | N/A | ||
 Admission to special care nursery or neonatal intensive care | Preterm | 208 (2) | 0.98 (0.74, 1.30) | 0.88 | 2% | 0.12 |
Term | 191 (1) | 5.24 (0.64, 42.66) | 0.12 | N/A | ||
 Hypothermia | Preterm | 911 (8) | 0.57 (0.29, 1.11) | 0.10 | 64% | 0.68 |
Term | 590 (5) | 0.43 (0.13, 1.43) | 0.17 | 79% | ||
 Exclusive breastmilk feeding at discharge | Preterm | 126 (2) | 2.01 [0.62, 6.58] | 0.25 | 88% | 0.39 |
Term | 482 (5) | 1.19 [1.00, 1.41] | 0.05 | 39% | ||
 Exclusive breastmilk feeding within the period from discharge to 3 months | Preterm | 154 (3) | 2.42 [1.44, 4.08] | 0.0009 | 0% | 0.03 |
Term | 781 (7) | 1.36 (1.23, 1.51) |  < 0.0001 | 0% | ||
 Any breastmilk feeding at discharge | Preterm | 69 (2) | 1.44 [1.00, 2.06] | 0.05 | 0% | 0.15 |
Term | 30 (1) | 1.07 [0.89, 1.28] | 0.47 | N/A | ||
 Any breastmilk feeding within the period from discharge to 3 months | Preterm | 38 (1) | 4.50 [1.13, 17.85] | 0.03 | N/A | 0.04 |
Term | 80 (1) | 7.40 [3.24, 16.88] |  < 0.0001 | N/A | ||
 Blood glucose concentration | Preterm | 70 (1) | -0.48 [-1.58, 0.62] | 0.39 | N/A | 0.22 |
Term | 94 (2) | 0.31 [-0.29, 0.90] | 0.32 | 78% | ||
Vaginal birth versus caesarean birth | ||||||
 Neonatal hypoglycaemia | Vaginal birth | 163 (2) | 0.20 (0.06, 0.67)a | 0.009 | N/A | 0.02 |
Caesarean section | 253 (2) | 1.56 (0.42, 5.85) | 0.51 | 0% | ||
 Admission to special care nursery or neonatal intensive care | Vaginal birth | 274 (1) | 0.42 (0.15, 1.15) | 0.09 | N/A | 0.28 |
Caesarean section | 304 (2) | 1.49 (0.18, 12.04) | 0.71 | 71% | ||
 Hypothermia | Vaginal birth | 1056 (9) | 0.48 (0.19, 1.24) | 0.13 | 86% | 0.34 |
Caesarean section | 446 (4) | 0.89 (0.38, 2.09) | 0.79 | 81% | ||
 Hyperthermia | Vaginal birth | 163 (2) | 0.78 (0.41, 1.48) | 0.52 | 0% | 0.58 |
Caesarean section | 142 (2) | 0.47 (0.23, 0.95) | 0.04 | 0% | ||
 Exclusive breastmilk feeding at discharge | Vaginal birth | 415 (3) | 1.19 [0.99, 1.43] | 0.06 | 67% | 0.90 |
Caesarean section | 305 (3) | 1.21 (0.96, 1.54) | 0.11 | 0% | ||
 Exclusive breastmilk feeding within the period from discharge to 3 months | Vaginal birth | 1081 (10) | 1.35 [1.17, 1.55] |  < 0.0001 | 58% | 0.71 |
Caesarean section | 34 (1) | 1.60 (0.66, 3.91) | 0.30 | N/A | ||
 Blood glucose concentration | Vaginal birth | 167 (2) | 0.56 [0.31, 0.80] |  < 0.0001 | 0% | 0.02 |
Caesarean section | 44 (1) | 0.00 [-0.40, 0.40] | 1.00 | N/A |