Resources for evidence-based practice, September-October 2003.

This column highlights new resources that clarify knowledge about effects of specific practices in maternal/newborn and women's health. The focus is on new and recently updated systematic reviews and overviews of best research evidence. The column identifies recent additions to three major evidence-based databases: • Cochrane Database of Systematic Reviews (CDSR) uses a standardized method to minimize bias and review studies that evaluate effects of specific health care practices. This Cochrane collaboration product is a leading source of high-quality reviews. • Database of Abstracts of Reviews of Effects (DARE) is a compilation of structured abstracts of quality-assessed systematic reviews. Staff at the United Kingdom National Health Service's Centre for Reviews and Dissemination use quality criteria to determine whether a review is included and to develop abstracts. • Clinical Evidence is a source of overviews of the best available research about effects of interventions. These overviews from the BMJ Publishing Group generally examine multiple questions (for example, prevention and treatment) about specific health concerns. The column also identifies recent evidence-based research reviews from other sources, and ends with a commentary. Early skin-to-skin contact for mothers and their healthy newborn infants. Early skin-to-skin contact between mothers and newborns is a widespread characteristic of mam-malian biology, including human evolution until the 20th century. In light of diverse research suggesting that early separation of mothers and infants may be harmful, this review was conducted to examine effects of early skin-to-skin contact between mothers and their healthy newborns on breastfeeding, other maternal and infant behaviors, physiology, psychology , and other outcomes. The review summarizes 16 randomized controlled trials and 1 quasi-random-ized trial that met the authors' criteria for relevance and methodologic adequacy. Collectively, the studies included 806 mother-infant pairs with diverse socioeconomic backgrounds from six different countries. The authors describe the overall methodologic quality of the studies as " marginally adequate. " The contact began at birth or up to 24 hours after birth. Mother-baby pairs with early skin-to-skin contact had significantly better performance on all measures of breastfeeding status and duration in the eight studies that examined this topic. Infants with early skin-to-skin contact were more likely to maintain temperature in the neutral thermal range (all four studies measuring infant temperature outcomes), were less likely to cry (both studies examining this outcome), and had higher blood glucose (one study) and a lower respiratory rate (one study). Overall, in the eight studies that examined maternal …