Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis

Abstract

CONTEXT: Kangaroo mother care (KMC) is an intervention aimed at improving outcomes among preterm and low birth weight newborns.OBJECTIVE: Conduct a systematic review and meta-analysis estimating the association between KMC and neonatal outcomes. STUDY SELECTION:We included randomized trials and observational studies through April 2014 examining the relationship between KMC and neonatal outcomes among infants of any birth weight or gestational age. Studies with <10 participants, lack of a comparison group without KMC, and those not reporting a quantitative association were excluded. DATA EXTRACTION:Two reviewers extracted data on study design, risk of bias, KMC intervention, neonatal outcomes, relative risk (RR) or mean difference measures.RESULTS: 1035 studies were screened; 124 met inclusion criteria. Among LBW newborns, KMC compared to conventional care was associated with 36% lower mortality(RR 0.64; 95% [CI] 0.46, 0.89). KMC decreased risk of neonatal sepsis (RR 0.53, 95% CI 0.34, 0.83), hypothermia (RR 0.22; 95% CI 0.12, 0.41), hypoglycemia (RR 0.12; 95% CI 0.05, 0.32), and hospital readmission (RR 0.42; 95% CI 0.23, 0.76) and increased exclusive breastfeeding (RR 1.50; 95% CI 1.26, 1.78). Newborns receiving KMC had lower mean respiratory rate and pain measures, and higher oxygen saturation, temperature, and head circumference growth. LIMITATIONS:Lack of data on KMC limited the ability to assess dose-response. CONCLUSIONS:Interventions to scale up KMC implementation are warranted. Epidemiology, c Biostatistics, and d Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Departments of b Global Health and Population, and f Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts; e Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts; g Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts; h Save the Children, Washington, DC; and i Department of Medicine, Boston Children's Hospital, Boston, Massachusetts Dr Boundy conceptualized and designed the study, conducted the literature review, collected the data, conducted the analyses, created the tables and fi gures, and drafted and revised the manuscript; Dr Dastjerdi conducted the literature review, collected and cleaned the data, assisted with table and fi gure creation, and critically reviewed the manuscript; Dr Spiegelman contributed to the study design, statistical analyses, and data interpretation and critically reviewed the manuscript; Drs Fawzi, Missmer, and Lieberman contributed to the study design and data interpretation and critically reviewed the manuscript; Ms Kajeepeta conducted the literature review, collected the data, assisted with fi gure creation, and critically reviewed the manuscript;Dr Wall contributed to the conceptualization and design of the study and data interpretation and critically reviewed the manuscript; Dr Chan conceptualized and designed the study, designed...

A Concept Map of Neonatal Hypoglycemia

“…After birth, breastfeeding-related problems must be prevented, as they can be a cause of metabolic disorders, including derangements in blood glucose. This could be prevented by strict hypoglycemia prevention protocols [23] or by existing, well-established programs (kangaroo mother care) [24].…”

“…The wording of questionnaire items was guided by keywords selected on the basis of the recent literature on the topic. Multiple-choice questions were also based on the literature [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

The Significance and Effectiveness of Kangaroo Care for Premature Infants

“…It has been reported that, thanks to kangaroo care, early initiation and promotion of mother-infant attachment makes the adaptation between mother and infant easier [9]. Kangaroo care means putting the naked baby with a diaper on its mother's or father's bare chest in a face-to-face upright position to establish skin-to-skin contact [6,10]. The name kangaroo care was inspired by the way a mother kangaroo holds her baby in her pouch.…”

“…Kangaroo care was initiated by Dr. Edger Rey Sanabria in Bogotá, Colombia in 1978, because neonatal intensive care units were too crowded and resources were inadequate, although rates of mortality and morbidity were high for babies with very low birth weights [6,10]. It is a current issue that kangaroo care should be considered very important due to its low cost, ease of application and positive effects on premature infants (Head 2014).…”

“…It is a current issue that kangaroo care should be considered very important due to its low cost, ease of application and positive effects on premature infants (Head 2014). Today in many hospitals, mothers are educated about the importance of kangaroo care, and the number of neonatal infections and deaths related to premature birth has prominently decreased [10]. In some developing countries of the world with limited technological opportunities, kangaroo care increases the chance of survival of premature infants.…”