Effects of daily kangaroo care on cardiorespiratory parameters in preterm infants

A J Mitchell, C Yates, K Williams, R W Hall, A J Mitchell, C Yates, K Williams, R W Hall

Abstract

Background/aims: Kangaroo care (KC) has possible benefits for promoting physiological stability and positive developmental outcomes in preterm infants. The purpose of this study was to compare bradycardia and oxygen desaturation events in preterm infants in standard incubator care versus KC.

Methods: Thirty-eight infants 27 to 30 weeks gestational age were randomly assigned to 2 hours of KC daily between days of life 5 to 10 or to standard incubator care. Infants were monitored for bradycardia (heart rate <80) or oxygen desaturation (<80%). Analysis of hourly events was based on three sets of data: standard care group 24 hours daily, KC group during incubator time 22 hours daily, and KC group during holding time 2 hours daily.

Results: The KC group had fewer bradycardia events per hour while being held compared to time spent in an incubator (p = 0.048). The KC group also had significantly fewer oxygen desaturation events while being held than while in the incubator (p = 0.017) and significantly fewer desaturation events than infants in standard care (p = 0.02).

Conclusion: KC reduces bradycardia and oxygen desaturation events in preterm infants, providing physiological stability and possible benefits for neurodevelopmental outcomes.

Keywords: Infant; bradycardia; kangaroo care; oxygen desaturation; premature.

Conflict of interest statement

Conflict of Interest

The authors declare no conflict of interest for this study

Figures

Figure 1
Figure 1
Hourly means of bradycardia over five days. *main effect of treatment group p=0.02
Figure 2
Figure 2
Hourly means of oxygen desaturation over five days. *main effect of treatment group p=0.0015
Figure 3
Figure 3
Enrollment flow diagram for infants in study to examine cardiorespiratory effects of kangaroo care

References

    1. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Kirmeyer S, et al. Births: final data for 2007. Natl Vital Stat Rep. 2010;58:1–85.
    1. March of Dimes. March of Dimes 2012 Premature Birth Report Card. March of Dimes; 2012. Available from: URL: .
    1. Heron M, Sutton PD, Xu J, Ventura SJ, Strobino DM, Guyer B. Annual summary of vital statistics: 2007. Pediatrics. 2010;125:4–15.
    1. Carroll JL, Agarwal A. Development of ventilatory control in infants. Paediatr Respir Rev. 2010;11:199–207.
    1. Rojas MA, Lozano JM, Rojas MX, Laughon M, Bose CL, Rondon MA, et al. Very early surfactant without mandatory ventilation in premature infants treated with early continuous positive airway pressure: a randomized, controlled trial. Pediatrics. 2009;123:137–42.
    1. Carroll JL. Developmental plasticity in respiratory control. J Appl Physiol. 2003;94:375–89.
    1. Abu-Shaweesh JM, Martin RJ. Neonatal apnea: What’s new? Pediatric Pulmonology. 2008;43:937–44.
    1. Lopez ES, Rodriguez EM, Navarro CR, Sanchez-Luna M. Initial respiratory management in preterm infants and bronchopulmonary dysplasia. Clinics (Sao Paulo) 2011;66:823–7.
    1. Pillekamp F, Hermann C, Keller T, von Gontard A, Kribs A, Roth B. Factors influencing apnea and bradycardia of prematurity - implications for neurodevelopment. Neonatology. 2007;91:155–61.
    1. Martin RJ, Wang K, Koroglu O, Di Fiore J, Kc P. Intermittent hypoxic episodes in preterm infants: do they matter? Neonatology. 2011;100:303–10.
    1. Thomas CW, Meinzen-Derr J, Hoath SB, Narendran V. Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants Ventilated with Continuous Positive Airway Pressure vs. Mechanical Ventilation Indian J Pediatr. 2012;79:218–23.
    1. Patrianakos-Hoobler AI, Msall ME, Huo D, Marks JD, Plesha-Troyke S, Schreiber MD. Predicting school readiness from neurodevelopmental assessments at age 2 years after respiratory distress syndrome in infants born preterm. Dev Med Child Neurol. 2010;52:379–85.
    1. Aarnoudse-Moens CS, Weisglas-Kuperus N, van Goudoever JB, Oosterlaan J. Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics. 2009;124:717–28.
    1. Jeng SF, Hsu CH, Tsao PN, Chou HC, Lee WT, Kao HA, et al. Bronchopulmonary dysplasia predicts adverse developmental and clinical outcomes in very-low-birthweight infants. Dev Med Child Neurol. 2008;50:51–7.
    1. Short EJ, Klein NK, Lewis BA, Fulton S, Eisengart S, Kercsmar C, et al. Cognitive and academic consequences of bronchopulmonary dysplasia and very low birth weight: 8-year-old outcomes. Pediatrics. 2003;112:e359.
    1. Ludington-Hoe SM, Anderson GC, Swinth JY, Thompson C, Hadeed AJ. Randomized controlled trial of kangaroo care: cardiorespiratory and thermal effects on healthy preterm infants. Neonatal Netw. 2004;23:39–48.
    1. Bosque EM, Brady JP, Affonso DD, Wahlberg V. Physiologic measures of kangaroo versus incubator care in a tertiary-level nursery. J Obstet Gynecol Neonatal Nurs. 1995 Mar;24:219–26.
    1. Bohnhorst B, Heyne T, Peter CS, Poets CF. Skin-to-skin (kangaroo) care, respiratory control, and thermoregulation. J Pediatr. 2001 Feb;138:193–7.
    1. Bohnhorst B, Gill D, Dordelmann M, Peter CS, Poets CF. Bradycardia and desaturation during skin-to-skin care: no relationship to hyperthermia. J Pediatr. 2004 Oct;145:499–502.
    1. Cong X, Ludington-Hoe SM, McCain G, Fu P. Kangaroo Care modifies preterm infant heart rate variability in response to heel stick pain: Pilot study. Early Human Development. 2009;85:561–7.
    1. Johnston CC. Kangaroo mother care diminishes pain from heel lance in very preterm neonates: a crossover trial. Pediatrics. 2008;8:13.
    1. Bellieni CV, Bagnoli F, Perrone S, Nenci A, Cordelli DM, Fusi M, et al. Effect of multisensory stimulation on analgesia in term neonates: a randomized controlled trial. Pediatr Res. 2002 Apr;51:460–3.
    1. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, et al. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009 Jun;98:932–9.
    1. Sharma PB, Baroody F, Gozal D, Lester LA. Obstructive sleep apnea in the formerly preterm infant: an overlooked diagnosis. Front Neurol. 2011;2:73.
    1. Calhoun SL, Vgontzas AN, Mayes SD, Tsaoussoglou M, Sauder K, Mahr F, et al. Prenatal and perinatal complications: is it the link between race and SES and childhood sleep disordered breathing? J Clin Sleep Med. 2010;6:264–9.
    1. Bhat RY, Hannam S, Pressler R, Rafferty GF, Peacock JL, Greenough A. Effect of prone and supine position on sleep, apneas, and arousal in preterm infants. Pediatrics. 2006;118:101–7.
    1. Reher C, Kuny KD, Pantalitschka T, Urschitz MS, Poets CF. Randomised crossover trial of different postural interventions on bradycardia and intermittent hypoxia in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2008;93:F289–F291.
    1. Heimann K. Impact of skin to skin care, prone and supine positioning on cardiorespiratory parameters adn thermoregulation in premature infants. Neonatology. 2010;97:311–7.
    1. Bauschatz AS, Kaufmann CM, Haensse D, Pfister R, Bucher HU. A preliminary report of nursing in the three-stair-position to prevent apnoea of prematurity. Acta Paediatr. 2008;97:1743–5.
    1. Poets CF. Interventions for apnoea of prematurity: a personal view. Acta Paediatr. 2010;99:172–7.

Source: PubMed

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