Impact of kangaroo mother care on continuous positive airway pressure success in preterm newborns: a randomized controlled trial

Abstract

This open-label parallel randomized control trial compared the need for invasive ventilation and continuous positive airway pressure (CPAP) duration in preterm infants receiving CPAP with or without kangaroo mother care (KMC). Preterm neonates from 28 to 36 weeks 6 days with a Downe's score ≥4 to 6 were eligible for CPAP and were recruited at Shree Krishna Hospital, Gujarat. Using balanced randomization, 111 participants were randomly assigned to two groups. KMC was initiated within one hour of CPAP versus in non-KMC group, neonates were placed under servo-controlled warmer with CPAP. The mean [standard deviation (SD) birth weights (1876.91 [456.51] vs. 1909.98 [387.46] grams] and gestational ages [32.5 (2.6) vs. 32.3 (2.8) weeks] were comparable between groups. The mean (SD) KMC hours in the intervention group before weaning from CPAP were 9.57 (7.72) hours. The success rate (without the requirement for invasive mechanical ventilation) was higher in the intervention group (92.6% vs. 75.4%, P = 0.01). Among neonates who were successfully weaned off ventilation, the mean (SD) CPAP hours were lower in the intervention group [23.19 (20.33) vs. 37.66 (24.40), P = 0.003]. The mean (SD) FIO2 [38.37 (13.36) vs. 44.88 (15.73), P = 0.02] and positive end expiratory pressure (PEEP) [6.30 (0.66) vs. 6.72 (0.70), P = 0.01] requirements were lower in the KMC intervention group, the thermoregulation was better, and there was earlier establishment of feeds. Provision of KMC in preterm newborns requiring CPAP at birth leads to reduced duration of CPAP support and CPAP failure.

Clinical trial registration: CTRI/2014/12/005309 [Registered on: 17/12/2014].

Keywords: infant; noninvasive ventilation; premature; respiratory distress syndrome.