TY - JOUR
T1 - Immediate “kangaroo mother care” and survival of infants with low birth weight
AU - Arya, Sugandha
AU - Naburi, Helga
AU - Kawaza, Kondwani
AU - Newton, Sam
AU - Anyabolu, Chineme H.
AU - Bergman, Nils
AU - Rao, Suman P.N.
AU - Mittal, Pratima
AU - Assenga, Evelyne
AU - Gadama, Luis
AU - Larsen-Reindorf, Roderick
AU - Kuti, Oluwafemi
AU - Linnér, Agnes
AU - Yoshida, Sachiyo
AU - Chopra, Nidhi
AU - Ngarina, Matilda
AU - Msusa, Ausbert T.
AU - Boakye-Yiadom, Adwoa
AU - Kuti, Bankole P.
AU - Morgan, Barak
AU - Minckas, Nicole
AU - Suri, Jyotsna
AU - Moshiro, Robert
AU - Samuel, Vincent
AU - Wireko-Brobby, Naana
AU - Rettedal, Siren
AU - Jaiswal, Harsh V.
AU - Sankar, M. Jeeva
AU - Nyanor, Isaac
AU - Tiwary, Hiresh
AU - Anand, Pratima
AU - Manu, Alexander A.
AU - Nagpal, Kashika
AU - Ansong, Daniel
AU - Saini, Isha
AU - Aggarwal, Kailash C.
AU - Wadhwa, Nitya
AU - Bahl, Rajiv
AU - Westrup, Bjorn
AU - Adejuyigbe, Ebunoluwa A.
AU - Plange-Rhule, Gyikua
AU - Dube, Queen
AU - Chellani, Harish
AU - Massawe, Augustine
N1 - Publisher Copyright:
Copyright © 2021 Massachusetts Medical Society.
PY - 2021/5/27
Y1 - 2021/5/27
N2 - BACKGROUND “Kangaroo mother care,” a type of newborn care involving skin-to-skin contact with the mother or other caregiver, reduces mortality in infants with low birth weight (<2.0 kg) when initiated after stabilization, but the majority of deaths occur before stabilization. The safety and efficacy of kangaroo mother care initiated soon after birth among infants with low birth weight are uncertain. METHODS We conducted a randomized, controlled trial in five hospitals in Ghana, India, Malawi, Nigeria, and Tanzania involving infants with a birth weight between 1.0 and 1.799 kg who were assigned to receive immediate kangaroo mother care (intervention) or conventional care in an incubator or a radiant warmer until their condition stabilized and kangaroo mother care thereafter (control). The primary outcomes were death in the neonatal period (the first 28 days of life) and in the first 72 hours of life. RESULTS A total of 3211 infants and their mothers were randomly assigned to the intervention group (1609 infants with their mothers) or the control group (1602 infants with their mothers). The median daily duration of skin-to-skin contact in the neonatal intensive care unit was 16.9 hours (interquartile range, 13.0 to 19.7) in the intervention group and 1.5 hours (interquartile range, 0.3 to 3.3) in the control group. Neonatal death occurred in the first 28 days in 191 infants in the intervention group (12.0%) and in 249 infants in the control group (15.7%) (relative risk of death, 0.75; 95% confidence interval [CI], 0.64 to 0.89; P=0.001); neonatal death in the first 72 hours of life occurred in 74 infants in the intervention group (4.6%) and in 92 infants in the control group (5.8%) (relative risk of death, 0.77; 95% CI, 0.58 to 1.04; P=0.09). The trial was stopped early on the recommendation of the data and safety monitoring board owing to the finding of reduced mortality among infants receiving immediate kangaroo mother care. CONCLUSIONS Among infants with a birth weight between 1.0 and 1.799 kg, those who received immediate kangaroo mother care had lower mortality at 28 days than those who received conventional care with kangaroo mother care initiated after stabilization; the between-group difference favoring immediate kangaroo mother care at 72 hours was not significant.
AB - BACKGROUND “Kangaroo mother care,” a type of newborn care involving skin-to-skin contact with the mother or other caregiver, reduces mortality in infants with low birth weight (<2.0 kg) when initiated after stabilization, but the majority of deaths occur before stabilization. The safety and efficacy of kangaroo mother care initiated soon after birth among infants with low birth weight are uncertain. METHODS We conducted a randomized, controlled trial in five hospitals in Ghana, India, Malawi, Nigeria, and Tanzania involving infants with a birth weight between 1.0 and 1.799 kg who were assigned to receive immediate kangaroo mother care (intervention) or conventional care in an incubator or a radiant warmer until their condition stabilized and kangaroo mother care thereafter (control). The primary outcomes were death in the neonatal period (the first 28 days of life) and in the first 72 hours of life. RESULTS A total of 3211 infants and their mothers were randomly assigned to the intervention group (1609 infants with their mothers) or the control group (1602 infants with their mothers). The median daily duration of skin-to-skin contact in the neonatal intensive care unit was 16.9 hours (interquartile range, 13.0 to 19.7) in the intervention group and 1.5 hours (interquartile range, 0.3 to 3.3) in the control group. Neonatal death occurred in the first 28 days in 191 infants in the intervention group (12.0%) and in 249 infants in the control group (15.7%) (relative risk of death, 0.75; 95% confidence interval [CI], 0.64 to 0.89; P=0.001); neonatal death in the first 72 hours of life occurred in 74 infants in the intervention group (4.6%) and in 92 infants in the control group (5.8%) (relative risk of death, 0.77; 95% CI, 0.58 to 1.04; P=0.09). The trial was stopped early on the recommendation of the data and safety monitoring board owing to the finding of reduced mortality among infants receiving immediate kangaroo mother care. CONCLUSIONS Among infants with a birth weight between 1.0 and 1.799 kg, those who received immediate kangaroo mother care had lower mortality at 28 days than those who received conventional care with kangaroo mother care initiated after stabilization; the between-group difference favoring immediate kangaroo mother care at 72 hours was not significant.
UR - http://www.scopus.com/inward/record.url?scp=85106949451&partnerID=8YFLogxK
U2 - 10.1056/NEJMoa2026486
DO - 10.1056/NEJMoa2026486
M3 - Article
C2 - 34038632
AN - SCOPUS:85106949451
SN - 0028-4793
VL - 384
SP - 2028
EP - 2038
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 21
ER -