Effect of kangaroo mother care on cerebral hemodynamics of very preterm neonates on non-invasive respiratory support- A prospective observational study

In neonates who were born before term gestation especially before 34 weeks it is believed to cause an interruption in their smooth and integrated neurobehavioral development.

Preterm neonates are more susceptible to neuronal injury because of their physiological immaturities in cerebral vasculature and ineffective cerebral autoregulation which can cause marked fluctuations in cerebral blood flow. This results in adverse cerebrovascular events which can have longterm effects on neurodevelopment in the form of cognitive, motor and behavioral abnormalities.

The advances in perinatal and neonatal medicine over the past two decades improved the survival of extreme and very preterm neonates which also resulted in increased neuro-morbidity among the survivors. Hence neuroprotective strategies should be made an integral part of neonatal care thereby promoting better longterm neurodevelopmental outcomes.

Kangaroo Mother Care (KMC) is a proven and effective method of care for preterm infants which means skin-to-skin contact (SSC) between the neonate and the parent especially the mother. Preterm birth results in an increase in number of days of NICU stay and separation of newborn and the mother. This SSC between mother and the baby promotes a multi-sensory stimulation for their development.

As only few studies have shown the beneficial effects of KMC on cerebral hemodynamics in very preterm neonates who are given SSC as early as possible even on non-invasive respiratory support we wish to analyze the changes to make KMC an integral part of neuroprotective care among the neonates.

Most of the studies done on stable preterm neonates were around the gestational age of 30-34 weeks of gestation and less data on neonates between 26-30 weeks of gestation who require more days of respiratory support which might effect their neurodevelopmental outcomes and these are the newborns who are separated from their parents for a longer time and hence this study might help in giving earlier and aggressive KMC as part of developmentally supportive care in these newborns. The studies were done in a single session and the consistency of the results has not been studied well. In this study we wanted to study for at least a period of 3 days to know the efficacy in a broader way.