title: Earlier versus later continuous Kangaroo Mother Care (KMC) for stable low-birth-weight infants: a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to examine the effectiveness of earlier continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country.
  
  
  METHODS
  A randomized controlled trial was performed in LBW infants at a referral hospital in Madagascar. Earlier continuous KMC (intervention) was begun as soon as possible, within 24 h postbirth, and later continuous KMC (control: conventional care) was begun after complete stabilization (generally after 24 h postbirth). Main outcome measure was mortality during the first 28 days postbirth. This trial was registered with ClinicalTrials.gov, NCT00531492.
  
  
  RESULTS
  A total of 73 infants (intervention 37, control 36) were included. Earlier continuous KMC had higher but no statistically different mortality in the first 28 days postbirth (1 vs. 2; risk ratio, 1.95; 95% CIs, 0.18-20.53; p = 1.00). There were no differences in incidence of morbidities. Body weight loss from birth to 24 h postbirth was significantly less in earlier KMC infants compared with later KMC infants. (-34.81 g vs. -73.97 g; mean difference, 39.16 g; 95% CIs, 10.30-68.03; p = 0.01; adjusted p = 0.02). Adverse events and duration of hospitalization were not different between the two groups.
  
  
  CONCLUSIONS
  Further evaluations of earlier continuous KMC including measurement of KMC dose, are needed in resource-limited countries.
authors.affiliation: Department of Health Informatics, School of Public Health, Kyoto University, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nagai
authors.forename: D
authors.initials: D
authors.lastname: Andrianarimanana
authors.forename: N
authors.initials: N
authors.lastname: Rabesandratana
authors.forename: N
authors.initials: N
authors.lastname: Yonemoto
authors.forename: T
authors.initials: T
authors.lastname: Nakayama
authors.forename: R
authors.initials: R
authors.lastname: Mori
mesh_terms: D005260:Female; D006785:Hospitals, University; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D057194:Intention to Treat Analysis; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D013997:Time Factors