Authors
- . Mahdi Jafari
- . Fatemeh Farajzadeh 1
- . Zoleikha Asgharlu 2
- . Naser Derakhshani 3
- . Yousof Pashaei Asl 4
1 Department of Health Services Management, School of Health Management and Information Sciences, International Campus (IUMS-IC), Iran University of Medical Sciences, Tehran, Iran
2 Department of Midwifery, Zanjan University of Medi
3 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
4 Department of Health Services Management, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Results of previous studies about the effect of Kangaroo Mother Care (KMC) on hospital management
indicators (HMIs) (length of stay [LOS], readmission to hospital, parent satisfaction, and parent’s
preference for same postdelivery care) had high confusions. The aim of this study was to conduct a
systematic review and meta‑analysis of randomized controlled trials on the effect of KMC on HMI in
comparison with the conventional neonatal care (CNC). In this systematic review and meta‑analysis
study, required data were collected by searching the following keywords: “length of stay,” “readmission
to hospital,” satisfaction,” same post‑delivery,” “hospital management,” indicators, “skin‑to‑skin,”
“Kangaroo Mother Care,” randomized trial. The following databases were searched: Google Scholar,
PubMed, EMBASE, Scopus, and Cochrane. To estimate the hospital management indicators,
computer software Comprehensive Meta‑Analysis 2 was used. Finally, 18 articles were included
to analysis. The overall LOS standard different between groups (KMC vs. CNC) was − 0.91 days
(95% confidence interval [CI], −2.14–0.32, Q = 25.6, df = 10, P = 0.004, I
2 = 60.98). The overall
readmission to hospital standard different between groups was − 1.78% (95% CI, −1.21%–0.86%,
Q = 0.024, df = 1, P = 0.87, I
2 = 0.00). The overall parent satisfaction standard different between
groups was 5.3% (95% CI, −32.4%–43%, Q = 0.052, df = 2, P = 0.97, I
2 = 0.00). The overall standard
different between groups was 16.2% (95% CI, −24.7%–57.1%, Q = 0.040, df = 1, P = 0.84, I
2 = 0.00).
KMC improves HMI but not significantly. According to the current study result and other studies that
report positive effect of KMC on health status of the newborns and parents, implemented of KMC in
low‑ and middle‑income countries recommended.
Keywords
2. Shrivastava SR, Shrivastava PS, Ramasamy J. Inequality in health
for women, infants, and children: An alarming public health
concern. Int J Prev Med 2016;7:10.
3. Azami‑Aghdash S, Ghojazadeh M, Dehdilani N, Mohammadi M,
Asl Amin Abad R. Prevalence and causes of cesarean section in
Iran: Systematic review and meta‑analysis. Iran J Public Health
2014;43:545‑55.
4. Ghojazadeh M, Velayati A, Mallah F, Azami‑Aghdash S, Mirnia K,
Piri R, et al. Contributing death factors in very low‑birth‑weight
infants by path method analysis. Niger Med J 2014;55:389‑93.
5. Chavda P, Misra S. Evaluation of input and process components
of quality of child health services provided at 24 × 7 primary
health centers of a district in central gujarat. J Family Med Prim
Care 2015;4:352‑8.
6. McMillen JC, Raffol M. Characterizing the quality workforce in
private U.S. Child and family behavioral health agencies. Adm
Policy Ment Health 2016;43:750‑9.
7. Miller NP, Amouzou A, Hazel E, Degefie T, Legesse H, Tafesse M,
et al. Assessing the quality of sick child care provided by
community health workers. PLoS One 2015;10:e0142010.
8. Shah AY, LLanos K, Dougherty D, Cha S, Conway PH. State
challenges to child health quality measure reporting and
recommendations for improvement. Healthc (Amst) 2016;4:217‑24.
9. Sharma A, Rana SK, Prinja S, Kumar R. Quality of health
management information system for maternal & child health care
in Haryana state, India. PLoS One 2016;11:e0148449.
10. Tabrizi JS, Farahbakhsh M, Shahgoli J, Rahbar MR,
Naghavi‑Behzad M, Ahadi HR, et al. Designing excellence and
quality model for training centers of primary health care: A Delphi
method study. Iran J Public Health 2015;44:1367‑75.
11. Forster DA, McLachlan HL. Breastfeeding initiation and birth
setting practices: A review of the literature. J Midwifery Womens
Health 2007;52:273‑80.
12. Chan GJ, Valsangkar B, Kajeepeta S, Boundy EO, Wall S. What is
kangaroo mother care? Systematic review of the literature. J Glob
Health 2016;6:6.
13. Castral TC, Warnock F, Leite AM, Haas VJ, Scochi CG. The effects
of skin‑to‑skin contact during acute pain in preterm newborns.
Eur J Pain 2008;12:464‑71.
14. Johnston CC, Filion F, Campbell‑Yeo M, Goulet C, Bell L,
McNaughton K, et al. Kangaroo mother care diminishes pain
from heel lance in very preterm neonates: A crossover trial. BMC
Pediatr 2008;8:13.
15. Chan GJ, Labar AS, Wall S, Atun R. Kangaroo mother care:
A systematic review of barriers and enablers. Bull World Health
Organ 2016;94:130‑41J.
16. Chiu SH, Anderson GC. Effect of early skin‑to‑skin contact
on mother‑preterm infant interaction through 18 months:
Randomized controlled trial. Int J Nurs Stud 2009;46:1168‑80.
17. Dezhdar S, Jahanpour F, Firouz Bakht S, Ostovar A. The effects
of kangaroo mother care and swaddling on venipuncture pain
in premature neonates: A Randomized clinical trial. Iran Red
Crescent Med J 2016;18:e29649.
18. Swarnkar K, Vagha J. Effect of kangaroo mother care on growth
and morbidity pattern in low birth weight infants. J Krishna Inst
Med Sci Univ 2016;5:91‑9.
19. Maleki D, Ghojazadeh M, Mahmoudi SS, Mahmoudi SM,
Pournaghi‑Azar F, Torab A, et al. Epidemiology of oral
cancer in Iran: A Systematic review. Asian Pac J Cancer Prev
2015;16:5427‑32.
20. Azami‑Aghdash S, Ghojazadeh M, Sheyklo SG, Daemi A,
Kolahdouzan K, Mohseni M, et al. Breast cancer screening barriers
from the womans perspective: A Meta‑synthesis. Asian Pac J
Cancer Prev 2015;16:3463‑71.
21. Ghojazadeh M, Hajebrahimi S, Pournaghi‑Azar F, Mohseni M,
Derakhshani N, Azami‑Aghdash S, et al. Effect of kangaroo
mother care on successful breastfeeding: A systematic review
and meta‑analysis of randomised controlled trials. Rev Recent
Clin Trials 2019;14:31‑40.
22. Acharya N, Singh RR, Bhatta NK, Poudel P. Randomized control
trial of kangaroo mother care in low birth weight babies at a
tertiary level hospital. J Nepal Paediatr Soc 2014;34:18‑23.
23. Boo NY, Jamli FM. Short duration of skin‑to‑skin contact:
Effects on growth and breastfeeding. J Paediatr Child Health
2007;43:831‑6.
24. Kadam S, Binoy S, Kanbur W, Mondkar JA, Fernandez A.
Feasibility of kangaroo mother care in Mumbai. Indian J Pediatr
2005;72:35‑8.
25. Roberts KL, Paynter C, McEwan B. A comparison of kangaroo
mother care and conventional cuddling care. Neonatal Netw
2000;19:31‑5.
26. Rojas MA, Kaplan M, Quevedo M, Sherwonit E, Foster L,
Ehrenkranz RA, et al. Somatic growth of preterm infants during
skin‑to‑skin care versus traditional holding: A randomized,
controlled trial. J Dev Behav Pediatr 2003;24:163‑8.
27. Mohseni M, Alikhani M, Tourani S, Azami‑Aghdash S, Royani S,
Moradi‑Joo M, et al. Rate and causes of discharge against
medical advice in Iranian hospitals: A Systematic review and
meta‑analysis. Iran J Public Health 2015;44:902‑12.
28. SKhan K, Kunz R, Kleijnen J, Antes G. Systematic Reviews to
Support Evidence‑Based Medicine. Crc Press; 2011 Feb 25.
29. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA
Group. Preferred reporting items for systematic reviews and
meta‑analyses: The PRISMA statement. Ann Intern Med
2009;151:264‑9, W64.
30. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA
Group. Preferred reporting items for systematic reviews and meta‑analyses: The PRISMA statement. PLoS Med
2009;6:e1000097.
31. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA
Group. Preferred reporting items for systematic reviews and
meta‑analyses: The PRISMA statement. Open Med 2009;3:e123‑30.
32. Higgins JP, Green S, editors. Cochrane Handbook for Systematic
Reviews of Interventions. Version 5.0.2.: The Cochrane
Collaboration; 2009.
33. Carfoot S, Williamson P, Dickson R. A randomised controlled
trial in the north of england examining the effects of skin‑to‑skin
care on breast feeding. Midwifery 2005;21:71‑9.
34. Dehghani K, MovahedZ, Dehghani H, Nasiriani K. A randomized
controlled trial of kangaroo mother care versus conventional
method on vital signs and arterial oxygen saturation rate in
newborns who were hospitalized in neonatal intensive care unit.
J Clin Neonatol 2015;4:26‑31.
35. Charpak N, Ruiz‑Pelaez JG, Figueroa de C Z, Charpak Y.
A randomized, controlled trial of kangaroo mother care: Results
of follow‑up at 1 year of corrected age. Pediatrics 2001;108:1072‑9.
36. Gathwala G, Singh B, Singh J. Effect of kangaroo mother care on
physical growth, breastfeeding and its acceptability. Trop Doct
2010;40:199‑202.
37. Mahmood I, Jamal M, Khan N. Effect of mother‑infant early
skin‑to‑skin contact on breastfeeding status: A randomized
controlled trial. J Coll Physicians Surg Pak 2011;21:601‑5.
38. Srivastava S, Gupta A, Bhatnagar A, Dutta S. Effect of very
early skin to skin contact on success at breastfeeding and
preventing early hypothermia in neonates. Indian J Public Health
2014;58:22‑6.
39. Suman RP, Udani R, Nanavati R. Kangaroo mother care for low
birth weight infants: A randomized controlled trial. Indian Pediatr
2008;45:17‑23.
40. Ghavane S, Murki S, Subramanian S, Gaddam P, Kandraju H,
Thumalla S, et al. Kangaroo mother care in kangaroo ward
for improving the growth and breastfeeding outcomes when
reaching term gestational age in very low birth weight infants.
Acta Paediatr 2012;101:e545‑9.
41. Nagai S, Yonemoto N, Rabesandratana N, Andrianarimanana D,
Nakayama T, Mori R, et al. Long‑term effects of earlier
initiated continuous kangaroo mother care (KMC) for
low‑birth‑weight (LBW) infants in madagascar. Acta Paediatr
2011;100:e241‑7.
42. Ramanathan K, Paul VK, Deorari AK, Taneja U, George G.
Kangaroo mother care in very low birth weight infants. Indian J
Pediatr 2001;68:1019‑23.
43. Gouchon S, Gregori D, Picotto A, Patrucco G, Nangeroni M,
Di Giulio P, et al. Skin‑to‑skin contact after cesarean delivery: An
experimental study. Nurs Res 2010;59:78‑84.
44. Ali SM, Sharma J, Sharma R, Alam S. Kangaroo mother care as
compared to conventional care for low birth weight babies. Dicle
Med J 2009;36:3.
45. Boundy EO, Dastjerdi R, Spiegelman D, Fawzi WW, Missmer SA,
Lieberman E, et al. Kangaroo mother care and neonatal outcomes:
A meta‑analysis. Pediatrics 2016;137(1):e20152238.
46. Conde‑Agudelo A, Díaz‑Rossello JL. Kangaroo mother care
to reduce morbidity and mortality in low birthweight infants.
Cochrane Database Syst Rev 2014;4:CD002771.
47. Jafari M, Bayat Mokhtari A, Kermansaravi A. The effect
of kangaroo mother care on weight gain, stay lengthh and
controlling temperature of preterm neonates with low birth
weight in neonatal intensive care units of selected hospitals in
Mashhad. Surg Nurs J 2014;3:32‑7.
48. Mohammadzadeh A, Farhat A, Jafarzadeh M, Hasanzadeh L,
Esmaeli H. Advantages of kangaroo mother care in less than
2000 grams low birth weight neonates. Med J Islamic Repub Iran
2011;25:11‑5.
49. Sloan NL, Camacho LW, Rojas EP, Stern C. Kangaroo mother
method: Randomised controlled trial of an alternative method
of care for stabilised low‑birthweight infants. Maternidad Isidro
Ayora study team. Lancet 1994;344:782‑5.
50. Marlow N. Family friendly care. BMJ 2004;329:1182.
51. de Macedo EC, Cruvinel F, Lukasova K, D’Antino ME. The
mood variation in mothers of preterm infants in kangaroo
mother care and conventional incubator care. J Trop Pediatr
2007;53:344‑6.
52. Tallandini MA, Scalembra C. Kangaroo mother care and
mother‑premature infant dyadic interaction. Infant Ment Health
J 2006;27:251‑75.
)