Elsevier

Early Human Development

Volume 122, July 2018, Pages 22-31
Early Human Development

Kangaroo mother care and infant biopsychosocial outcomes in the first year: A meta-analysis

https://doi.org/10.1016/j.earlhumdev.2018.05.004Get rights and content

Highlights

  • KMC for vulnerable neonates has a lasting impact during infancy.

  • KMC demonstrates benefits in infant self-regulation.

  • KMC demonstrates moderate effects in cognitive and motor development.

Abstract

Aim

A systematic review and meta-analysis was conducted to examine the relationship between KMC and infant/toddler biopsychosocial outcomes.

Method

PubMed, MEDLINE (OvidSP), MEDLINE in Process (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), and AMED (OvidSP) were searched. Observational studies and randomized control trials through October 2015 that investigated the association between KMC intervention and infant/toddler biopsychosocial outcomes were included. Studies with <10 participants, those using skin-to-skin only during painful procedures or only on the day of birth, and those that did not report quantitative outcomes were excluded. Data were extracted by two coders and estimates were examined using random-effects.

Results

3177 studies were screened with 13 meeting inclusion criteria and representing 5 child outcomes (cognitive, motor, self-regulation, socio-emotional and temperament). Among LBW/premature neonates, KMC compared to conventional care was associated with improved infant self-regulation. Moderated effects were identified for cognitive (duration of KMC) and motor development (duration of KMC, country-level mortality ratio, and infant gender).

Interpretations

KMC administered to vulnerable neonates during a sensitive period of brain development has a lasting impact on self-regulation skills later in infancy. Further research examining the longer-term effect of KMC on cognitive and motor development, socioemotional skills, and temperament is needed.

Section snippets

Search strategy

Searches were conducted in MEDLINE, Embase, PsycINFO, Cinahl and AMED (from database inception to October 2015) by a health sciences librarian. Both database specific subject headings and text word fields were searched for the concepts “kangaroo care” and “infants”. Synonymous terms were first combined with the Boolean “OR”. These two concepts were then combined with the Boolean “AND”. In all databases, truncation symbols and adjacency operators were used in text word searches when appropriate,

Results

The search strategy yielded 3177 (out of which, 479 were marked as duplicates) studies. Out of those, 413 articles were assessed for eligibility, and among these, 13 were included in the meta-analysis. See Fig. 1 for a flow chart of study screening. The number of outcomes among the 13 studies was as follows: cognitive (n = 9), motor (n = 8), self-regulation (n = 4), socio-emotional (n = 4) and temperament (n = 5). We tested whether study design (i.e. observation versus RCT) affected the

Summary of the evidence

Through a systematic review of the literature, we report results of the first meta-analysis examining the effects of KMC on biopsychosocial outcomes in the first year. KMC is targeted to a preterm population. Infants exposed to KMC show significantly better emotion regulation than infants exposed to usual care. No effects were found in any other parameters examined. However, exploring the role of potential moderators, duration of KMC was associated with cognitive and motor development, and

Acknowledgments

We are grateful to the Atkinson Charitable Foundation (#2011-5018), the Lawson Foundation, and The Margaret and Wallace McCain Family Foundation (#2013-69) for providing financial support to the contributors of this study.

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