Did You Know: Effects of Kangaroo Mother Care in the NICU on the Physiological Stress Parameters of Premature Infants: A Meta-Analysis of RCTs

Despite the numerous cited benefits of kangaroo care in the NICU, establishing consistent opportunities for skin to skin holding in the NICU remains challenging in many units. This study completed a meta-analysis of RCTs on physiological stress parameters among preterm infants during kangaroo mother care compared to conventional neonatal care. Physiological measures of stress included: heart rate, respiratory rate, oxygen saturation, and body temperature. Other stress measures were excluded due to insufficient evidence for validity. Conventional neonatal care was described as incubator care in preterm infants.

Articles were identified utilizing EMBASE, SCOPUS, PubMed, CINAHL, and Cochrane. Exclusion criteria included: no report of infant physiological outcomes, no comparison group, no data on measured effects, no outcomes for preterm infants with a gestational age of 37 weeks or less, intervention was during a painful or stressful procedure, studies with 10 or less participates, and non-human participants. Two reviewers screened articles for eligibility and came to a consensus to include 12 studies in the meta-analysis. 

Respiratory rate was found to be statistically improved with kangaroo mother care vs conventional care (p< 0.00001), which clinically supports decreased neonatal stress. During kangaroo mother care, infants had higher mean heart rate, oxygen saturation, and temperature, though not statistically significant, suggests clinical stability. Of note, moderate variability between studies was identified when reviewing heart rate, temperature, and oxygen saturation.

This meta-analysis found that kangaroo mother care does not have negative outcomes in comparison to standard incubator care, even among infants as young as 28 weeks. Additionally, kangaroo mother care can be provided for prolonged periods of time without compromising the preterm infant, and may have a positive impact on certain physiological markers. Due to the many long-term benefits associated with kangaroo care and the prolonged separation of infant-mother dyads during extended hospital stays, it is extremely important preterm infants receive kangaroo care for optimal care in the NICU. Further research should include larger sample sizes, standardized outcomes, and improved study designs with increased transparency and comprehensive reporting.

Cristóbal Cañadas, D., Bonillo Perales, A., Galera Martínez, R., Casado-Belmonte, M. D. P., & Parrón Carreño, T. (2022). Effects of Kangaroo Mother Care in the NICU on the Physiological Stress Parameters of Premature Infants: A Meta-Analysis of RCTs. International Journal of Environmental Research and Public Health19(1), 583. https://doi.org/10.3390/ijerph19010583