Effectiveness of Kangaroo Mother Care in Intubated Preterm Neonates 28 to 36 Weeks Gestational Age, Weighing 600 to 2000 Grams at Birth: A Randomized Controlled Trial

  • Shary May M. Baton Section of Newborn Medicine, Philippine General Hospital, University of the Philippines Manila
  • Maria Esterlita T. Villanueva-Uy Section of Newborn Medicine, Philippine General Hospital, University of the Philippines Manila
  • Socorro De Leon-Mendoza Section of Newborn Medicine, Philippine General Hospital, University of the Philippines Manila
Keywords: Kangaroo Mother Care, intubated preterm neonates, neonatal mortality, intubation days

Abstract

Background. Kangaroo Mother Care (KMC) is the standard of care for stable low birth weight infants. Provision of KMC to intubated preterm infants may also be beneficial, but strong evidence is still lacking.

Objective. To determine the effectiveness of KMC in decreasing mortality among intubated preterm neonates.

Study Design. This is a non-blinded, parallel, non-inferiority randomized controlled trial.

Methodology. All intubated, preterm admissions, 28-36 weeks gestation, weighing 600-2000 grams, with respiratory distress were included. They were randomized to the intervention group who received KMC for 2-4 hours daily while intubated and the control group who received care inside an incubator. Participants’ physiologic status – before, during, and after the intervention – was recorded. The primary outcome was mortality. Secondary outcomes included comorbidities, days intubated, and hospital stay.

Results. There was a total of 32 patients. The risk of dying in the KMC group (n=16) was significantly reduced by 78% (RR 0.22; 95% CI 0.06 - 0.87 p=0.009). The KMC patients were also less likely to have hypothermia, nosocomial pneumonia, NEC, and late-onset neonatal sepsis (p<0.05). The KMC group had higher blood sugar levels (110 vs. 58, p=0.001) and required fewer days of intubation (3.5 vs.1.5 days, p<0.000) compared to the control group. There was no difference in the duration of the hospital stay.

Conclusion. KMC is effective in decreasing mortality among intubated preterm neonates. Other comorbidities and days of intubation were also reduced.

Published
2021-12-21