A post-hoc analysis of the previous iKMC trial (N Engl J Med 2021;384:2028-2038) which was conducted in five level 2 Newborn Intensive Care Units in Ghana, India, Malawi, Nigeria, and Tanzania, in neonates with birth weight 1 to <1.8 kg. The intervention was immediate KMC continued until discharge, compared to conventional KMC initiated after meeting stability criteria. 1609 newborns were enrolled in the intervention group and 1602 newborns in the control group. There were no significant differences in cardiorespiratory parameters during the first four postnatal days. Skin-to-skin contact starting immediately after birth is safe in low birth weight infants in limited-resource settings.