Table 1 Characteristics of studies included in systematic review

Afand et al. (2021)

N = 70

32–37 wGA,

only mothers included

Massage with almond oil “(1) from the head down to the neck and vice versa, (2) from the upper back down to the waist,

and vice versa” for 8 min once a day for 2 days: 4 min by the mother, and 4 min by a healthcare professional.

Standard medical care only. No massage.

Maternal anxiety: State-Trait Anxiety Inventory (STAI)

STAI

Longitudinal measurement in both groups: day before discharge (T1, before intervention for the experimental group)

and discharge day (T2)

STAI scores decreased significantly between T1 and T2 in both groups. At T2, the massage group’s STAI scores were significantly lower than those of the control group.

Erduran et al. [56]

N = 60,

< 37 + 6 wGA,

only mothers included

Kangaroo care 30 min per day for 10 days.

Standard medical care only. No kangaroo care.

Edinburgh Postnatal Depression Scale (EPDS)

Maternal Attachment Inventory (MAI)

MAI

30–40 days after birth

The EPDS scores of the kangaroo care group were lower than those of the control group, but the difference was not statistically significant.

Feldman et al. [54]

N = 146,

25–34 wGA,

only mothers included

Skin-to-skin care 1 h per day for 14 days.

Standard medical care only. No skin-to-skin care.

Physiological measures: heart rate, sleep, cortisol level

Cognitive measures: Bayley Scale of Infant Development, Wechsler Intelligence Scale for Children (WISC), and NEPSY

Measurement of early interactions: Coding Interactive Behavior (CIB)

Measures of maternal anxiety and depressive symptoms:

STAI, EPDS, Parental Stress Index (PSI)

Not specified

At 3 months, 6 months, and 10 years (corrected age)

The STAI and PSI scores of the skin-to-skin group were significantly lower at 3 months and 6 months (corrected age). This difference was no longer significant at 10 years. There was no significant difference in BDI scores between the two groups.

Gholami et al. [31]

N = 90,

28–36 wGA, only mothers included

Two intervention groups:

1. Massage: Tactile stimulation by moderate touching of the head, neck, shoulders, back and lower limbs. Kinesthetic stimulation by arm and hand movements for 5 min 3 times a day until discharge.

2. Kangaroo care for between 20 min and 3 h 3 times a day until discharge.

Standard medical care only. No massage or kangaroo care.

Neonatal Infant Pain Scale (NIPS)

STAI

STAI

Longitudinal measurements at hospitalization (T1, before intervention for massage and skin-to-skin groups) and at discharge (T2, after intervention)

The STAI scores of the massage group were lower than those of the kangaroo care group, but this difference was not statistically significant. The STAI scores of the massage and skin-to-skin groups were significantly lower than those of the control group.

Herizchi et al. [27]

N = 60,

< 37 wGA, only mothers included

More than 3 h of skin-to-skin care daily for 1 month.

Less than 3 h of skin-to-skin care per day for 1 month.

EPDS

EPDS

10, 20 and 30 days after childbirth

No significant difference between groups at D10. The EPDS scores of the experimental group were significantly lower than those of the control group at D20 and D30. Between D10 and D30, the EPDS scores of the experimental group decreased, while the scores of the control group increased.

Karimi et al. [32]

N = 90,

28–36 + 6 wGA, only mothers included

Two intervention groups:

1. Massage: “with the infants in a prone position, applying moderate pressure stroking to the head, shoulders, back, legs and arms for 5 minutes, (2) kinesthetic stimulation consisting of flexing and extending the limbs in a supine position for the next 5 minutes, and (3) returning the infant to the prone position and repeating the moderate pressure massage stroking sequence for the last 5 min (same as the first 5 minutes).” 3 times a day for 5 days.

2. 15 min kangaroo mother care twice a day for 5 days.

Standard medical care only. No massage or kangaroo mother care.

Depression, Anxiety and Stress Scale (DASS-21)

NIPS

Coping Responses Inventory for Adults (CRI-A)

DASS-21

Longitudinal measurements before and 5 days after the interventions for each group

Levels of anxiety, stress, and depressive symptoms were significantly lower in the massage and kangaroo mother care groups than in the control group after the interventions. There was no significant difference between the massage and kangaroo mother care groups.

Mokaberian et al. (2021)

N = 40,

32–37 wGA, only mothers included

Massage with 8 min of tactile stimulation + 4 min of kinesthetic stimulation + 8 min of tactile stimulation 3 times a day for 10 days.

Standard medical care only. No massage.

Neonatal Behavioural Assessment Scale (NABS)

Peabody Development Motor Scale (PDMS)

Maternal Postnatal Attachment Scale (MPAS)

STAI

Not specified

Not specified

The STAI scores of the massage group were significantly lower than those of the control group.

Mörelius et al. [57]

N = 42,

32–35 + 6 wGA, mothers and fathers included

Continuous skin-to-skin care until discharge.

Unrestricted skin-to-skin care (i.e., as many times as the parent wished).

Physiological measurement: cortisol level

Measurement of parental anxiety and depressive symptoms:

Swedish Parenthood Stress Questionnaire (SPSQ)

EPDS

Interview including questions about breastfeeding

SPSQ and EPDS

At 1 month and 4 months (CA)

No significant difference between groups on SPSQ scores.

The EPDS scores of the continuous skin-to-skin group were lower than those of the unrestricted skin-to-skin group for the mothers, but this difference was not significant.

Ochandorena-Acha et al. [58]

N = 48,

28–34 wGA, only mothers included

Between 32 and 36 wGA: 10 min of tactile stimulation with moderate pressure + 5 min of kinesthetic stimulation by movements of the upper and lower limbs. Twice a day for 10 days.

Between 40 wGA and 2 months (CA): positions and movements facilitating motor development and exploration of objects, with 4 home supervision visits. 15–20 min twice a day for 5 days a week.

Newborn Individualized Developmental

Care and Assessment Program (NIDCAP)

Alberta Infant

Motor Scale (AIMS)

Ages and Stages Questionnaires

Third Edition (ASQ-3)

Parenting Stress Index-Short Form (PSI-SF)

AIMS

AIMS at 2 and 8 months (CA), ASQ-3 at 1 month (CA), PSI-SF at 3 months (CA)

No significant difference between the groups.

Rao et al. [55]

N = 50,

< 37 wGA, only mothers included

Kangaroo mother care minimum 4 h per day for 1 week.

No control group.

Hospital Anxiety and Depression Scale (HADS)

HADS

Longitudinal measurement at D0 (T1, before intervention) and D7 (T2, after intervention)

Levels of anxiety and depressive symptoms were significantly lower after the intervention.

Sweeney et al. [28]

N = 116,

< 34 wGA, mothers and fathers included

Skin-to-skin care for 30 min twice a day.

No control group.

STAI

STAI

Longitudinal measurement before and after intervention (minimum 1 h of skin-to-skin care)

STAI scores were significantly lower after the intervention.