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Kangaroo mother care to reduce morbidity and mortality in low birthweight infants.
Cochrane Database Syst Rev. 2011 Mar 16CD

Abstract

BACKGROUND

Kangaroo mother care (KMC), originally defined as skin-to-skin contact between a mother and her newborn, frequent and exclusive or nearly exclusive breastfeeding, and early discharge from hospital, has been proposed as an alternative to conventional neonatal care for low birthweight (LBW) infants.

OBJECTIVES

To determine whether there is evidence to support the use of KMC in LBW infants as an alternative to conventional neonatal care.

SEARCH STRATEGY

The standard search strategy of the Cochrane Neonatal Group was used. This included searches of MEDLINE, EMBASE, LILACS, POPLINE, CINAHL databases (from inception to January 31, 2011), and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2011). In addition, we searched the web page of the Kangaroo Foundation, conference and symposia proceedings on KMC, and Google scholar.

SELECTION CRITERIA

Randomized controlled trials comparing KMC versus conventional neonatal care, or early onset KMC (starting within 24 hours after birth) versus late onset KMC (starting after 24 hours after birth) in LBW infants.

DATA COLLECTION AND ANALYSIS

Data collection and analysis were performed according to the methods of the Cochrane Neonatal Review Group.

MAIN RESULTS

Sixteen studies, including 2518 infants, fulfilled inclusion criteria. Fourteen studies evaluated KMC in LBW infants after stabilization, one evaluated KMC in LBW infants before stabilization, and one compared early onset KMC with late onset KMC in relatively stable LBW infants. Eleven studies evaluated intermittent KMC and five evaluated continuous KMC. At discharge or 40 - 41 weeks' postmenstrual age, KMC was associated with a reduction in the risk of mortality (typical risk ratio (RR) 0.60, 95% confidence interval (CI) 0.39 to 0.93; seven trials, 1614 infants), nosocomial infection/sepsis (typical RR 0.42, 95% CI 0.24 to 0.73), hypothermia (typical RR 0.23, 95% CI 0.10 to 0.55), and length of hospital stay (typical mean difference 2.4 days, 95% CI 0.7 to 4.1). At latest follow up, KMC was associated with a decreased risk of mortality (typical RR 0.68, 95% CI 0.48 to 0.96; nine trials, 1952 infants) and severe infection/sepsis (typical RR 0.57, 95% CI 0.40 to 0.80). Moreover, KMC was found to increase some measures of infant growth, breastfeeding, and mother-infant attachment.

AUTHORS' CONCLUSIONS

The evidence from this updated review supports the use of KMC in LBW infants as an alternative to conventional neonatal care mainly in resource-limited settings. Further information is required concerning effectiveness and safety of early onset continuous KMC in unstabilized LBW infants, long term neurodevelopmental outcomes, and costs of care.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Conde-Agudelo A
Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Detroit, Michigan, USA.
Belizán JM
No affiliation info available
Diaz-Rossello J
No affiliation info available

MeSH

HumansInfant CareInfant MortalityInfant, Low Birth WeightInfant, NewbornInfant, Premature, DiseasesLength of StayPhysical StimulationRandomized Controlled Trials as TopicWeight Gain

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

21412879

Clinical Trial Links

Implementation Research of Kangaroo Mother Care in Rural Pakistan.
Effects of Father-Neonate Skin-to-Skin Contact on Attachment

Citation

Conde-Agudelo, Agustin, et al. "Kangaroo Mother Care to Reduce Morbidity and Mortality in Low Birthweight Infants." The Cochrane Database of Systematic Reviews, 2011, p. CD002771.
Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2011.
Conde-Agudelo, A., Belizán, J. M., & Diaz-Rossello, J. (2011). Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. The Cochrane Database of Systematic Reviews, (3), CD002771. https://doi.org/10.1002/14651858.CD002771.pub2
Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo Mother Care to Reduce Morbidity and Mortality in Low Birthweight Infants. Cochrane Database Syst Rev. 2011 Mar 16;(3)CD002771. PubMed PMID: 21412879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. AU - Conde-Agudelo,Agustin, AU - Belizán,José M, AU - Diaz-Rossello,Jose, Y1 - 2011/03/16/ PY - 2011/3/18/entrez PY - 2011/3/18/pubmed PY - 2011/4/2/medline SP - CD002771 EP - CD002771 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 3 N2 - BACKGROUND: Kangaroo mother care (KMC), originally defined as skin-to-skin contact between a mother and her newborn, frequent and exclusive or nearly exclusive breastfeeding, and early discharge from hospital, has been proposed as an alternative to conventional neonatal care for low birthweight (LBW) infants. OBJECTIVES: To determine whether there is evidence to support the use of KMC in LBW infants as an alternative to conventional neonatal care. SEARCH STRATEGY: The standard search strategy of the Cochrane Neonatal Group was used. This included searches of MEDLINE, EMBASE, LILACS, POPLINE, CINAHL databases (from inception to January 31, 2011), and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2011). In addition, we searched the web page of the Kangaroo Foundation, conference and symposia proceedings on KMC, and Google scholar. SELECTION CRITERIA: Randomized controlled trials comparing KMC versus conventional neonatal care, or early onset KMC (starting within 24 hours after birth) versus late onset KMC (starting after 24 hours after birth) in LBW infants. DATA COLLECTION AND ANALYSIS: Data collection and analysis were performed according to the methods of the Cochrane Neonatal Review Group. MAIN RESULTS: Sixteen studies, including 2518 infants, fulfilled inclusion criteria. Fourteen studies evaluated KMC in LBW infants after stabilization, one evaluated KMC in LBW infants before stabilization, and one compared early onset KMC with late onset KMC in relatively stable LBW infants. Eleven studies evaluated intermittent KMC and five evaluated continuous KMC. At discharge or 40 - 41 weeks' postmenstrual age, KMC was associated with a reduction in the risk of mortality (typical risk ratio (RR) 0.60, 95% confidence interval (CI) 0.39 to 0.93; seven trials, 1614 infants), nosocomial infection/sepsis (typical RR 0.42, 95% CI 0.24 to 0.73), hypothermia (typical RR 0.23, 95% CI 0.10 to 0.55), and length of hospital stay (typical mean difference 2.4 days, 95% CI 0.7 to 4.1). At latest follow up, KMC was associated with a decreased risk of mortality (typical RR 0.68, 95% CI 0.48 to 0.96; nine trials, 1952 infants) and severe infection/sepsis (typical RR 0.57, 95% CI 0.40 to 0.80). Moreover, KMC was found to increase some measures of infant growth, breastfeeding, and mother-infant attachment. AUTHORS' CONCLUSIONS: The evidence from this updated review supports the use of KMC in LBW infants as an alternative to conventional neonatal care mainly in resource-limited settings. Further information is required concerning effectiveness and safety of early onset continuous KMC in unstabilized LBW infants, long term neurodevelopmental outcomes, and costs of care. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/21412879/Kangaroo_mother_care_to_reduce_morbidity_and_mortality_in_low_birthweight_infants_ L2 - https://doi.org/10.1002/14651858.CD002771.pub2 DB - PRIME DP - Unbound Medicine ER -