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Published on: September 22, 2023
The Relationship Between Kangaroo Mother Care Duration and Clinical Outcomes in Preterm and Low Birth-Weight Infants:
Yan Xiang1, Lu Qin, Yefang Zhu
1Author Affiliations: Changshu First People's Hospital, Changshu Hospital Affiliated to Soochow University, Changshu, Jiangsu Province, China (Xiang, Qin, Zhu, Xu and Mu).
Background:
Determining the optimal daily Kangaroo Mother Care (KMC) duration is important for improving outcomes in preterm and low birth-weight (LBW) infants, but existing evidence is mostly as broad categories rather than a continuous dose-response relationship.
Purpose:
To examine the dose-response association between daily KMC duration and 4 outcomes in preterm/LBW infants: weight gain and hospital stay (primary), breastfeeding (including direct feeding and receipt of expressed human milk) and hypothermia (secondary).
Data Sources:
PubMed, Web of Science, Cochrane Library, China Biology Medicine, Wanfang, China National Knowledge Infrastructure, and CQVIP Chinese Journals Platform were searched from inception to May 31, 2025.
Study Selection:
Randomized controlled trials comparing Kangaroo Mother Care to conventional care in preterm or low birth-weight infants were eligible. Thirty-six trials meeting PICOS criteria with extractable daily KMC duration and at least 1 outcome were included.
Data Extraction:
Two reviewers independently screened records, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2 tool. Disagreements were resolved by discussion or consultation with a third reviewer.
Results:
Across 36 RCTs (N = 4210), daily KMC duration had a nonlinear association with weight gain, with benefits increasing beyond approximately 11.8 hours per day. Hospital stay also showed a nonlinear association, with the greatest reduction at approximately 6 hours per day. Breastfeeding rates increased linearly with longer KMC duration, and each additional KMC hour lowered hypothermia odds. Because outcome trajectories differed, 6 hours per day best reduced hospital stay, while longer exposure may add growth benefit when feasible.
Implications For Practice And Research:
For preterm and LBW infants, use KMC when feasible. Approximately 6 hours per day reduces hospital stay; longer exposure may further benefit growth. Future trials should report daily and cumulative KMC exposure, initiation timing, daily continuation, and long-term outcomes.
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