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Early kangaroo care in preterm ≤32 weeks and very low birth weight infants: a systematic review and meta-analysis

Joana Arêde Martins1, Renato Ferreira-da-Silva2,3,4, André Assunção1,5

  • 1679497 Faculdade de Medicina da Universidade do Porto , Porto, Portugal.

Journal of Perinatal Medicine
|February 28, 2026
PubMed

Insights

Early Kangaroo care (KC), involving skin-to-skin contact, significantly reduces mortality risk in very preterm and very low birth weight infants. While infection risk was not significantly reduced, KC shows promise for improving neonatal outcomes.

Area of Science:

  • Neonatal Medicine
  • Pediatrics
  • Evidence-Based Healthcare

Background:

  • Kangaroo care (KC) is recognized for its benefits in preterm and low birth weight infants.
  • Early initiation of KC, including skin-to-skin contact and early breastfeeding, is crucial.

Purpose of the Study:

  • To evaluate the effectiveness of early Kangaroo care (KC) initiated within 24 hours.
  • To compare early KC versus conventional neonatal care for very preterm (≤32 weeks) and/or very low birth weight (<1,500g) infants.

Main Methods:

  • Systematic review and meta-analysis of four randomized controlled trials (RCTs).
  • Included 1,679 newborns comparing early KC to conventional care.
  • Risk of bias assessed using the Cochrane Risk of Bias tool; meta-analysis performed using R.

Main Results:

  • Early KC significantly reduced mortality risk (RR=0.81, 95% CI: 0.67-0.98).
  • Pooled risk ratio for infection was 0.89 (95% CI: 0.77-1.02), not statistically significant.
  • Observed mixed effects on hypothermia with moderate heterogeneity.

Conclusions:

  • Early KC demonstrates potential to decrease mortality and morbidity in very preterm and VLBW infants.
  • Further research is needed for infants <1,000g or born before 28 weeks gestation.
  • Effects on hypothermia warrant further investigation.
Abstract

Keywords:
infant careinfant mortalitykangaroo-mother care methodpremature birthsystematic reviewvery low birth weight

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