Effectiveness of kangaroo mother care for low-birth-weight infants during neonatal care and evidence supporting continuity of care after NICU discharge: A systematic review
https://doi.org/10.52235/lp.v7i4.1019
Keywords:
continuity of care, kangaroo mother care, low-birth-weight infants, NICUAbstract
Background: The benefits of Kangaroo Mother Care (KMC) for low-birth-weight (LBW) infants have been widely reported during hospitalization; however, the continuation of KMC after discharge from the Neonatal Intensive Care Unit (NICU) remains unclear.
Objective: To synthesize evidence from primary studies on the effectiveness of KMC among LBW infants in neonatal units and assess the extent to which this evidence supports continuity of KMC after discharge.
Methods: Eligible studies included randomized controlled trials (RCTs), secondary analyses of RCTs, and quasi-experimental studies involving LBW (<2,500 g) and/or preterm infants in neonatal units who received KMC or skin-to-skin contact (SSC), published in English or Indonesian between 2020 and July 2026. ClinicalKey for Nursing, ScienceDirect, ProQuest, and SAGE Journals were searched. Risk of bias was appraised using the JBI Critical Appraisal Checklists; findings were synthesized narratively following SWiM, and certainty of evidence was assessed using GRADE.
Results: Of 953 records, five primary studies (two RCTs, one secondary analysis of an RCT, and two single-group quasi-experimental studies; 435 infants) were included. Four studies evaluated KMC/SSC during hospitalization, and one evaluated a transitional developmental intervention package in which both groups received KMC; none evaluated KMC at home. Early SSC did not reduce hypothermia (4% vs. 7%; p = 0.68) but reduced hyperthermia (26% vs. 47%; p = 0.02). SSC immediately after birth reduced maternal depressive symptoms and paternal anxiety during the first week, but these effects did not persist at 3–4 or 12 months. Physiological and growth changes in single-group studies and improvements in cognitive scores with a transitional intervention package could not be attributed to KMC.
Conclusion: The certainty of evidence was low to very low. KMC/SSC appeared safe and was associated with physiological stability during neonatal care, but its effectiveness after discharge remains undetermined. Standardized studies of home-based KMC are needed.
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