Effectiveness of Reverse Kangaroo Mother Care Position in Decreasing Adverse Physiological Events and Pain during Screening of Premature Infants for Retinopathy of Prematurity

Abstract

Background. Retinopathy of prematurity (ROP) screening is uncomfortable and even painful in preterm infants.

Objective. To determine the effectiveness of the Reverse-Kangaroo Mother Care (R-KMC) position compared with the conventional position in decreasing adverse physiological events and pain during ROP screening.

Methods. This was a parallel randomized controlled trial with two arms- R-KMC position and conventional position (control). The primary outcomes included increased oxygen saturation, decreased heart and respiratory rates, and decreased pain intensity measured by Prematurity Infant Pain Profile (PIPP).

Results. There were 100 preterm infants recruited. There were no differences in baseline characteristics, mean ROP screening duration, mean physiological parameters after the mydriatic application and during ROP screening between the two. Only the mean respiratory rates were significantly lower among the R-KMC group during the application of mydriatric agent. (50.26 ± 6.18 vs. 51.6 ± 8.35; p=0.0191). Relative risk (RR) in the control group is 37 to 84 versus 40 to 68 in the R-KMC group. The R-KMC group had a significantly lower mean PIPP score (6.5±2.06 vs. 8.8±2.80; p<0.0001) after mydriatic application and during ROP screening (7.6±2.05 vs. 9.8±2.90; p<0.0001) compared with control. No apnea was observed after mydriatic application, but one apneic episode was in control during ROP screening. 26% of the ROP screeners recommended the R-KMC position during ROP screening, while a majority (70%) was neutral.

Conclusion. R-KMC position, a low-cost intervention, significantly reduces pain during ROP screening. It is recommended as a position of choice during ROP screening.