'Kangaroo mother care' to prevent neonatal deaths due to preterm birth complications
BACKGROUND: 'Kangaroo mother care' (KMC) includes thermal care through continuous skin-to-skin contact, support for exclusive breastfeeding or other appropriate feeding, and early recognition/response to illness. Whilst increasingly accepted in both high- and low-income countries, a Cochrane review (2003) did not find evidence of KMC's mortality benefit, and did not report neonatal-specific data.
OBJECTIVES: The objectives of this study were to review the evidence, and estimate the effect of KMC on neonatal mortality due to complications of preterm birth.
METHODS: We conducted systematic reviews. Standardized abstraction tables were used and study quality assessed by adapted GRADE methodology. Meta-analyses were undertaken.
RESULTS: We identified 15 studies reporting mortality and/or morbidity outcomes including nine randomized controlled trials (RCTs) and six observational studies all from low- or middle-income settings. Except one, all were hospital-based and included only babies of birth-weight <2000 g (assumed preterm). The one community-based trial had missing birthweight data, as well as other limitations and was excluded. Neonatal-specific data were supplied by two authors. Meta-analysis of three RCTs commencing KMC in the first week of life showed a significant reduction in neonatal mortality [relative risk (RR) 0.49, 95% confidence interval (CI) 0.29-0.82] compared with standard care. A meta-analysis of three observational studies also suggested significant mortality benefit (RR 0.68, 95% CI 0.58-0.79). Five RCTs suggested significant reductions in serious morbidity for babies <2000 g (RR 0.34, 95% CI 0.17-0.65).
CONCLUSION: This is the first published meta-analysis showing that KMC substantially reduces neonatal mortality amongst preterm babies (birth weight <2000 g) in hospital, and is highly effective in reducing severe morbidity, particularly from infection. However, KMC remains unavailable at-scale in most low-income countries.
| Errataetall: |
CommentIn: Int J Epidemiol. 2011 Apr;40(2):521-5. - PMID 21044980 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2010 |
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| Erschienen: |
2010 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 Suppl 1 |
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| Enthalten in: |
International journal of epidemiology - 39 Suppl 1(2010) vom: 04. Apr., Seite i144-54 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lawn, Joy E [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 27.04.2010 Date Revised 10.04.2022 published: Print CommentIn: Int J Epidemiol. 2011 Apr;40(2):521-5. - PMID 21044980 Citation Status MEDLINE |
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| doi: |
10.1093/ije/dyq031 |
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NLM196934583 |
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| 500 | |a CommentIn: Int J Epidemiol. 2011 Apr;40(2):521-5. - PMID 21044980 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: 'Kangaroo mother care' (KMC) includes thermal care through continuous skin-to-skin contact, support for exclusive breastfeeding or other appropriate feeding, and early recognition/response to illness. Whilst increasingly accepted in both high- and low-income countries, a Cochrane review (2003) did not find evidence of KMC's mortality benefit, and did not report neonatal-specific data | ||
| 520 | |a OBJECTIVES: The objectives of this study were to review the evidence, and estimate the effect of KMC on neonatal mortality due to complications of preterm birth | ||
| 520 | |a METHODS: We conducted systematic reviews. Standardized abstraction tables were used and study quality assessed by adapted GRADE methodology. Meta-analyses were undertaken | ||
| 520 | |a RESULTS: We identified 15 studies reporting mortality and/or morbidity outcomes including nine randomized controlled trials (RCTs) and six observational studies all from low- or middle-income settings. Except one, all were hospital-based and included only babies of birth-weight <2000 g (assumed preterm). The one community-based trial had missing birthweight data, as well as other limitations and was excluded. Neonatal-specific data were supplied by two authors. Meta-analysis of three RCTs commencing KMC in the first week of life showed a significant reduction in neonatal mortality [relative risk (RR) 0.49, 95% confidence interval (CI) 0.29-0.82] compared with standard care. A meta-analysis of three observational studies also suggested significant mortality benefit (RR 0.68, 95% CI 0.58-0.79). Five RCTs suggested significant reductions in serious morbidity for babies <2000 g (RR 0.34, 95% CI 0.17-0.65) | ||
| 520 | |a CONCLUSION: This is the first published meta-analysis showing that KMC substantially reduces neonatal mortality amongst preterm babies (birth weight <2000 g) in hospital, and is highly effective in reducing severe morbidity, particularly from infection. However, KMC remains unavailable at-scale in most low-income countries | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Horta, Bernardo L |e verfasserin |4 aut | |
| 700 | 1 | |a Barros, Fernando C |e verfasserin |4 aut | |
| 700 | 1 | |a Cousens, Simon |e verfasserin |4 aut | |
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