This three-arm RCT compared three tactile stimulation (TS) sites — sole rub, trunk rub, and back rub — during initial neonatal resuscitation steps in 183 non-crying neonates ≥32 weeks' gestation, with SpO₂ at 5 minutes of life as the primary outcome.
No significant difference in 5-min SpO₂ across groups (sole rub: 83.1±11.7%, trunk rub: 85.4±11.9%, back rub: 82.4±14.8%; p=0.392); HR trends, cerebral oxygenation (CrSO₂) at 1 hour, need for further resuscitation, and in-hospital complications were also similar. No procedure-related complications occurred in any group.
- Study limited to neonates ≥32 weeks, so findings may not apply to more preterm infants. - FiO₂ trend difference favoring sole/trunk rub over back rub did not reach statistical significance, leaving a clinically meaningful signal unresolved. - Single-center RCT design limits generalizability.
Clinicians can use any of the three TS sites (sole, trunk, or back rub) during initial neonatal resuscitation without concern for differential effect on oxygenation or cerebral outcomes. Choice of TS site can be left to provider preference or circumstance.
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