Impact of Kangaroo Mother Care During Neonatal Transport on Clinical Outcomes: A Prospective Cohort Study

Abstract

Background: Neonatal transport in low- and middle-income countries (LMICs) is often associated with risks of hypothermia, desaturation, and other physiological instability. Kangaroo Mother Care (KMC), known for its thermoregulatory and physiological benefits, has been extensively studied in stable in-hospital neonates but less so during transport. This study evaluates the feasibility, safety, and physiological effects of KMC during neonatal transport in a resource-limited setting.

Methods: We conducted a prospective cohort study at a tertiary care NICU in Kolkata, India. Neonates requiring inter-facility transfer and meeting stability criteria for KMC were enrolled over six months. Those transported with KMC (intervention group) were compared to controls covered with blankets. Key outcomes included the incidence of hypothermia (axillary temperature <36.5°C), desaturation events, and heart rate variability during transport.

Results: A total of 208 neonates (104 KMC,104 controls) were analysed. The KMC group had significantly lower rates of hypothermia (37% vs 53%, p=0.01) and fewer desaturation episodes. Heart rate and oxygen saturation remained more stable during transport in the KMC group. No adverse events related to KMC were reported.

Conclusion: KMC during neonatal transport is a feasible, safe, and effective strategy to improve thermal and physiological stability in neonates, particularly in LMIC settings. Wider adoption of KMC transport protocols could reduce morbidity and improve neonatal outcomes.