Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis

Overview

Journal Pediatrics

Specialty Pediatrics

Date 2015 Dec 25

PMID 26702029

Citations 190

Authors

Ellen O Boundy

Roya Dastjerdi

Donna Spiegelman

Wafaie W Fawzi

Stacey A Missmer

Ellice Lieberman

Sandhya Kajeepeta

Stephen Wall

Grace J Chan

Affiliations

Soon will be listed here.

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.

Data Sources: PubMed, Embase, Web of Science, Scopus, African Index Medicus (AIM), Latin American and Caribbean Health Sciences Information System (LILACS), Index Medicus for the Eastern Mediterranean Region (IMEMR), Index Medicus for the South-East Asian Region (IMSEAR), and Western Pacific Region Index Medicus (WPRIM).

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.

Citing Articles

Differences in parental stress in mothers and fathers of preterm infants: A prospective study in Poland.

Zych B, Blaz W, Kanadys K, Dmoch-Gajzlerska E, Nagorska M Eur J Midwifery. 2025; 9.

PMID: 40061453 PMC: 11887512. DOI: 10.18332/ejm/200552.

An exploration of the support received by mothers for kangaroo mother care practice along the health facility-community continuum in a sub-district of Northern Karnataka, India.

Washington M, Macaden L, Mony P, Selvam S, Smith A PLoS One. 2025; 20(3):e0308738.

PMID: 40048468 PMC: 11884690. DOI: 10.1371/journal.pone.0308738.

Parental singing during kangaroo care: parents' experiences of singing to their preterm infant in the NICU.

Hugoson P, Haslbeck F, Aden U, Eulau L Front Psychol. 2025; 16:1440905.

PMID: 39968194 PMC: 11832525. DOI: 10.3389/fpsyg.2025.1440905.

Measuring the duration of kangaroo mother care for neonates: a scoping review.

Tumukunde V, Loucaides E, Medvedev M, Nyirenda M, Lawn J, Tann C BMJ Open. 2025; 15(1):e079579.

PMID: 39843372 PMC: 11758684. DOI: 10.1136/bmjopen-2023-079579.

Developmental trajectories in high-risk NICU graduates during the first year of life.

McDonald N, Qian Q, Ferrario C, Senturk D, Iyer S, Jeste S Early Hum Dev. 2024; 201:106183.

PMID: 39705921 PMC: 11830516. DOI: 10.1016/j.earlhumdev.2024.106183.

References

Niela-Vilen H, Axelin A, Salantera S, Lehtonen L, Tammela O, Salmelin R . Early physical contact between a mother and her NICU-infant in two university hospitals in Finland. Midwifery. 2013; 29(12):1321-30. DOI: 10.1016/j.midw.2012.12.018. View

Nimbalkar S, Patel V, Patel D, Nimbalkar A, Sethi A, Phatak A . Effect of early skin-to-skin contact following normal delivery on incidence of hypothermia in neonates more than 1800 g: randomized control trial. J Perinatol. 2014; 34(5):364-8. DOI: 10.1038/jp.2014.15. View

Thukral A, Sankar M, Agarwal R, Gupta N, Deorari A, Paul V . Early skin-to-skin contact and breast-feeding behavior in term neonates: a randomized controlled trial. Neonatology. 2012; 102(2):114-9. DOI: 10.1159/000337839. View

Whitelaw A, Heisterkamp G, Sleath K, Acolet D, Richards M . Skin to skin contact for very low birthweight infants and their mothers. Arch Dis Child. 1988; 63(11):1377-81. PMC: 1779160. DOI: 10.1136/adc.63.11.1377. View

Johnston C, Filion F, Campbell-Yeo M, Goulet C, Bell L, McNaughton K . Kangaroo mother care diminishes pain from heel lance in very preterm neonates: a crossover trial. BMC Pediatr. 2008; 8:13. PMC: 2383886. DOI: 10.1186/1471-2431-8-13. View

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

Higgins J, Thompson S . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186. View

Neu M, Robinson J, Schmiege S . Influence of holding practice on preterm infant development. MCN Am J Matern Child Nurs. 2013; 38(3):136-43. PMC: 3639437. DOI: 10.1097/NMC.0b013e31827ca68c. View

Scher M, Ludington-Hoe S, Kaffashi F, Johnson M, Holditch-Davis D, Loparo K . Neurophysiologic assessment of brain maturation after an 8-week trial of skin-to-skin contact on preterm infants. Clin Neurophysiol. 2009; 120(10):1812-8. PMC: 2928473. DOI: 10.1016/j.clinph.2009.08.004. View

10.

Broughton E, Gomez I, Sanchez N, Vindell C . The cost-savings of implementing kangaroo mother care in Nicaragua. Rev Panam Salud Publica. 2013; 34(3):176-82. View

11.

Chermont A, Falcao L, de Souza Silva E, Balda R, Guinsburg R . Skin-to-skin contact and/or oral 25% dextrose for procedural pain relief for term newborn infants. Pediatrics. 2009; 124(6):e1101-7. DOI: 10.1542/peds.2009-0993. View

12.

Lawn J, Cousens S, Zupan J . 4 million neonatal deaths: when? Where? Why?. Lancet. 2005; 365(9462):891-900. DOI: 10.1016/S0140-6736(05)71048-5. View

13.

Ahmed S, Mitra S, Chowdhury A, Camacho L, Winikoff B, Sloan N . Community Kangaroo Mother Care: implementation and potential for neonatal survival and health in very low-income settings. J Perinatol. 2011; 31(5):361-7. DOI: 10.1038/jp.2010.131. View

14.

Mahmood I, Jamal M, Khan N . Effect of mother-infant early skin-to-skin contact on breastfeeding status: a randomized controlled trial. J Coll Physicians Surg Pak. 2011; 21(10):601-5. DOI: 10.2011/JCPSP.601605. View

15.

Grunau R, Craig K . Pain expression in neonates: facial action and cry. Pain. 1987; 28(3):395-410. DOI: 10.1016/0304-3959(87)90073-X. View

16.

Furman L, Minich N, Hack M . Correlates of lactation in mothers of very low birth weight infants. Pediatrics. 2002; 109(4):e57. DOI: 10.1542/peds.109.4.e57. View

17.

Ohgi S, Fukuda M, Moriuchi H, Kusumoto T, Akiyama T, Nugent J . Comparison of kangaroo care and standard care: behavioral organization, development, and temperament in healthy, low-birth-weight infants through 1 year. J Perinatol. 2002; 22(5):374-9. DOI: 10.1038/sj.jp.7210749. View

18.

Cong X, Ludington-Hoe S, McCain G, Fu P . Kangaroo Care modifies preterm infant heart rate variability in response to heel stick pain: pilot study. Early Hum Dev. 2009; 85(9):561-7. PMC: 2742959. DOI: 10.1016/j.earlhumdev.2009.05.012. View

19.

Karlsson V, Heinemann A, Sjors G, Nykvist K, Agren J . Early skin-to-skin care in extremely preterm infants: thermal balance and care environment. J Pediatr. 2012; 161(3):422-6. DOI: 10.1016/j.jpeds.2012.02.034. View

20.

Campbell-Yeo M, Johnston C, Benoit B, Latimer M, Vincer M, Walker C . Trial of repeated analgesia with Kangaroo Mother Care (TRAKC Trial). BMC Pediatr. 2013; 13:182. PMC: 3828622. DOI: 10.1186/1471-2431-13-182. View