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

Abstract

Objective: The aim of this study was to analyze the randomised controlled trials that explored the effect of kangaroo mother care on physiological stress parameters of premature infants. Methods: Two independent researchers performed a systematic review of indexed studies in PubMed, Embase, CINAHL, Cochrane and Scopus. We included data from randomized controlled trials measuring the effects of kangaroo care compared to standard incubator care on physiological stress outcomes, defined as oxygen saturation, body temperature, heart rate and respiratory rate. The PRISMA model was used to conduct data extraction. We performed a narrative synthesis of all studies and a meta-analysis when data were available from multiple studies that compared the same physiological parameters with the kangaroo method as an intervention and controls and used the same outcome measures. Results: Twelve studies were eligible for inclusion in this meta-analysis. According to statistical analysis, the mean respiratory rate of preterm infants receiving KMC was lower than that of infants receiving standard incubator care (MD, −3.50; 95% CI, −5.17 to −1.83; p < 0.00001). Infants who received kangaroo mother care had a higher mean heart rate, oxygen saturation and temperature, although these results were not statistically significant. Conclusions: Current evidence suggests that kangaroo care in the neonatal intensive care unit setting is a safe method that may have a significant effect on some of the physiological parameters of stress in preterm infants. However, due to clinical heterogeneity, further studies are needed to assess the effects of physiological stress in the neonatal intensive care unit on the development of preterm infants.

Effect of Supportive Nursing Intervention on Maternal Stress and Selected Neonatal Outcomes

“…Improved infantmother interaction could have appositive effect on reducing pain and stress in premature infants. This finding was in line with Johnston et al, 2017, Johnston et al, 2018, Akcan et al, 2019and Souza-Vogler & Lima, 2021and Cristóbal Cañadas et al, 2022 They notified that supportive care helped to reduce levels of neonatal pain and stress.…”

Efficacy and safety of non-pharmacological interventions for neonatal pain: an overview of systematic reviews

“…SSC, also known as KC, refers to the way the mother holds a diaper-clad infant upright on her breast at approximately 60°, providing maximum skin-to-skin contact between the baby and mother 45. Studies have shown that KC can not only reduce pain and stabilise the physiological and behavioural responses of the neonates, but it also strengthens the mother–infant bonding 56 57. Furthermore, no significant difference in pain scores was found between the mother and other providers (father and another woman) 45.…”

Immediate skin-to-skin contact for low birth weight infants is safe in terms of cardiorespiratory stability in limited-resource settings

“… 16 A recent review described the heterogeneity of studies on SSC and cardiorespiratory outcomes. 17 A dose-response relationship has been hypothesized, but one study confirms a positive effect on the physiology of very low birth weight infants even with hour-long sessions of SSC. 18 The importance of early tactile stimulation for positive neurodevelopmental experiences is well-described, 19 , 20 as well as mother-infant separation as a source of toxic stress.…”