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Global child health
Kangaroo mother care for the prevention of neonatal hypothermia: a randomised controlled trial in term neonates
  1. Manimaran Ramani1,
  2. Eunjoo A Choe1,
  3. Meggin Major1,
  4. Rebecca Newton1,
  5. Musaku Mwenechanya1,2,
  6. Colm P Travers1,
  7. Elwyn Chomba1,2,3,
  8. Namasivayam Ambalavanan1,
  9. Waldemar A Carlo1,2
  1. 1 Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
  2. 2 Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
  3. 3 Department of Pediatrics, University Teaching Hospital, Lusaka, Zambia
  1. Correspondence to Dr Manimaran Ramani, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA; mramani{at}peds.uab.edu

Abstract

Objective To test the hypothesis that kangaroo mother care (KMC) initiated either at birth or at 1 hour after birth reduces moderate or severe hypothermia in term neonates at (A) 1 hour after birth and (B) at discharge when compared with standard thermoregulation care.

Methods Term neonates born at a tertiary delivery centre in Zambia were randomised in two phases (phase 1: birth to 1 hour, phase 2: 1 hour to discharge) to either as much KMC as possible in combination with standard thermoregulation care (KMC group) or to standard thermoregulation care (control group). The primary outcomes were moderate or severe hypothermia (axillary temperature <36.0°C) at (A) 1 hour after birth and (B) at discharge.

Results The proportion of neonates with moderate or severe hypothermia did not differ between the KMC and control groups at 1 hour after birth (25% vs 27%, relative risk (RR)=0.93, 95% CI 0.59 to 1.4, P=0.78) or at discharge (7% vs 2%, RR=2.8, 95% CI 0.6 to 13.9, P=0.16). Hypothermia was not found among the infants who had KMC for at least 9 hours or 80% of the hospital stay.

Conclusions KMC practised as much as possible in combination with standard thermoregulation care initiated either at birth or at 1 hour after birth did not reduce moderate or severe hypothermia in term infants compared with standard thermoregulation care. The current study also shows that duration of KMC either for at least 80% of the time or at least 9 hours during the day of birth was effective in preventing hypothermia in term infants.

Clinical trial registration NCT02189759.

  • hypothermia/prevention & control; infant
  • newborn; term infant
  • kangaroo mother care
  • skin-to-skin care

https://doi.org/10.1136/archdischild-2017-313744

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    Footnotes

    • Contributors MR conceptualised and designed the trial, implemented and carried out data collection, analysed and drafted the initial paper followed by reviewing, revising and approving the final manuscript as submitted. EAC, MM and RN implemented and conducted data collection and reviewed and approved the final manuscript as submitted. Colm P. Travers analysed the results and reviewed and approved the final manuscript as submitted. EC, MM and NA designed the trial, and reviewed and approved the final manuscript as submitted. WAC designed the trial and analysed the results and drafted the initial paper followed by reviewing, revising and approving the final manuscript as submitted.

    • Funding Supported in part by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Global Network for Women’s and Children’s Health Research (U01HD043464), the Perinatal Health and Human Development Research Program of the University of Alabama at Birmingham and the Children’s of Alabama Centennial Scholar Fund.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The institutional review board of the University of Alabama at Birmingham, USA, and the University of Zambia Research Ethics Committee in Lusaka, Zambia, approved the trial (Clinicaltrials.gov identifier NCT02189759).

    • Provenance and peer review Not commissioned; externally peer reviewed.