The Association Between Duration of Kangaroo Position and Neurodevelopment Among Preterm Infants
Abstract
Introduction and Objective. Premature delivery disrupts critical brain development and the stress of coping with the extrauterine environment further affects normal neurodevelopmental processes. Kangaroo Mother Care (KMC), particularly the kangaroo position, aims to mitigate the adverse effects of preterm birth. Skin-to-skin contact between mother and infant fosters a nurturing setting that resembles the natural intrauterine atmosphere. Our study aimed to identify the association between the duration of KMC and the neurodevelopment of preterm infants at one year of life. Methods. A historical cohort was assembled using medical records from “Programa Madre Canguro Integral-Fundación Canguro” in Bogota, Colombia from April 2020 to July 2023. Inclusion criteria were preterm infants (28-36 weeks gestational age) who were eligible for KMC and had follow-up information. Exclusion criteria included infants with a brain injury before starting KMC, severe malformation, or missing information on key variables. Exposure was the duration of the ‘Kangaroo’ position, categorized as 0, 1-15, 16-50, and more than 50 days. The outcome was neurodevelopment at the time of the last visit. Using logistic regression, ORs and 95% CI were computed while controlling for potential confounders. Results. The final effective sample size was 3,084 participants and 19.5% had some degree of abnormal neurodevelopment. Before adjustment, odds were significantly increased in infants with 50+ days of KP (3.46 [1.38-8.58]) compared to infants with 0 days of KP. After adjusting for mothers’ age, neonatal/perinatal asphyxia, intracranial hemorrhage, and bronchopulmonary dysplasia, there was no longer evidence of a statistically significant association between psychomotor delay and duration of KP (2.32 [0.91-5.91]). Other factors independently associated with psychomotor delay were perinatal/neonatal asphyxia and bronchopulmonary dysplasia. Conclusions-Implications. Prolonged KMC does not have any harmful effects on neurodevelopment, however, we were unable to determine if the increased duration of KMC improves outcomes for preterm infants. The current standard of practice is not to prescribe a duration but rather encourage the mother to maintain the KP for as long as the infant tolerates it.
Abstract Category
26. Pediatrics
Secondary Abstract Category
30. Other
Keywords
Preterm, Neurodevelopment, Kangaroo Mother Care, Prematurity
Presentation Type
Poster Presentation
The Association Between Duration of Kangaroo Position and Neurodevelopment Among Preterm Infants
Introduction and Objective. Premature delivery disrupts critical brain development and the stress of coping with the extrauterine environment further affects normal neurodevelopmental processes. Kangaroo Mother Care (KMC), particularly the kangaroo position, aims to mitigate the adverse effects of preterm birth. Skin-to-skin contact between mother and infant fosters a nurturing setting that resembles the natural intrauterine atmosphere. Our study aimed to identify the association between the duration of KMC and the neurodevelopment of preterm infants at one year of life. Methods. A historical cohort was assembled using medical records from “Programa Madre Canguro Integral-Fundación Canguro” in Bogota, Colombia from April 2020 to July 2023. Inclusion criteria were preterm infants (28-36 weeks gestational age) who were eligible for KMC and had follow-up information. Exclusion criteria included infants with a brain injury before starting KMC, severe malformation, or missing information on key variables. Exposure was the duration of the ‘Kangaroo’ position, categorized as 0, 1-15, 16-50, and more than 50 days. The outcome was neurodevelopment at the time of the last visit. Using logistic regression, ORs and 95% CI were computed while controlling for potential confounders. Results. The final effective sample size was 3,084 participants and 19.5% had some degree of abnormal neurodevelopment. Before adjustment, odds were significantly increased in infants with 50+ days of KP (3.46 [1.38-8.58]) compared to infants with 0 days of KP. After adjusting for mothers’ age, neonatal/perinatal asphyxia, intracranial hemorrhage, and bronchopulmonary dysplasia, there was no longer evidence of a statistically significant association between psychomotor delay and duration of KP (2.32 [0.91-5.91]). Other factors independently associated with psychomotor delay were perinatal/neonatal asphyxia and bronchopulmonary dysplasia. Conclusions-Implications. Prolonged KMC does not have any harmful effects on neurodevelopment, however, we were unable to determine if the increased duration of KMC improves outcomes for preterm infants. The current standard of practice is not to prescribe a duration but rather encourage the mother to maintain the KP for as long as the infant tolerates it.