Related Experiment Video
Updated: Jan 13, 2026
Author Spotlight: Understanding Retinal Vessel Resilience and Disease Progression
Published on: January 12, 2024
Effects of Kangaroo care during retinopathy screening examination: a randomised clinical trial
Hai-Bo Huang1,2, Yin Xue1, Yanxia Liang1
1Pediatrics, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Insights
Kangaroo care (K-care) significantly reduced pain and stress during retinopathy screening examinations for preterm infants. This intervention also lowered cortisol and inflammatory markers, suggesting a beneficial effect on infant well-being.
Area of Science:
- Neonatal care
- Pain management in infants
- Developmental pediatrics
Background:
- Retinopathy of prematurity (ROP) screening is a common but stressful procedure for preterm infants.
- Kangaroo care (K-care) is a method of holding a baby that can provide comfort during painful procedures.
- The effects of K-care on pain and inflammation during ROP screening need further investigation.
Purpose of the Study:
- To evaluate the effectiveness of K-care in reducing pain and stress during the first ROP screening examination (RSE) in preterm infants.
- To assess the impact of K-care on early pain-related and delayed inflammatory responses.
Main Methods:
- A randomized clinical trial was conducted in a family-centered neonatal intensive care unit.
- Preterm infants (<34+0 weeks gestation and/or <2000g birth weight) requiring RSE were randomly assigned to K-care or a control group.
- Pain was assessed using the Premature Infant Pain Profile (PIPP) score, and salivary samples were analyzed for cortisol, IL-1β, IL-6, and TNF-α levels.
Main Results:
- Infants receiving K-care had significantly lower PIPP scores compared to the control group.
- K-care group infants showed reduced salivary cortisol levels at 1 hour post-RSE.
- Significantly lower levels of interleukin-6 and TNF-α were observed in the K-care group at 6-8 hours post-RSE.
Conclusions:
- Kangaroo care may effectively reduce pain and stress associated with ROP screening in preterm infants.
- K-care appears to mitigate both immediate pain responses and delayed inflammatory markers.
- These findings support the integration of K-care into neonatal intensive care practices for painful procedures.
Objective:
Providing Kangaroo care (K-care) helps comfort infants through painful and stressful procedures including retinopathy screening examination (RSE) for retinopathy of prematurity. We examined the early pain-related and delayed inflammatory effects of K-care during the first RSE in preterm infants.
Design:
Randomised clinical trial.
Setting:
In a family-centred neonatal intensive care unit between 1 March 2023 and 31 August 2024.
Patients:
Preterm infants (gestation <34+0 weeks and/or birth weight <2000 g) who required RSEs.
Interventions:
Patients were randomly assigned to K-care provided by mother or father during RSE or control group on an examination table (n=50/group).
Main Outcome Measures:
The Premature Infant Pain Profile (PIPP) score within the first minute of RSE was measured. Salivary samples (>110 uL) were collected before, at 1 and 6-8 hours after RSE for assays of cortisol, interleukin-1β, interleukin-6 and tumour necrosis factor-alpha (TNF-α) levels by ELISA methods in a blinded fashion.
Results:
100 infants (mean±SD gestational age: 31.1±2.4 weeks; birth weight: 1496±452 g, 58% males) were enrolled. Compared with controls (n=50), infants of the K-care group (n=50) had significantly lower PIPP score (11.0 vs 12.9; p=0.002); salivary cortisol levels (4.9 vs 6.9 ng/mL; p=0.001) at 1 hour after RSE, interleukin-6 (31.9 vs 34.7 pg/mL; p=0.01) and TNF-α (53.9 vs 58.6 pg/mL; p=0.02), but not interleukin-1β (50.4 vs 53.0 pg/mL; p=0.46), levels at 6-8 hour after RSE.
Conclusions:
Providing K-care during RSE in preterm infants may potentially reduce pain-related stress, cortisol and inflammatory responses.
