Impact of kangaroo mother care on cerebral blood flow of preterm infants.
BACKGROUND
Kangaroo mother care (KMC) has been widely used to improve the care of preterms and low birth weight infants. However, very little is known about cerebral hemodynamics responses in preterm infants during KMC intervention. The aim of this study is to evaluate the changes of cerebral blood flow (CBF) in middle cerebral artery, before and after a 30 minute application of KMC in stable preterm infants.


METHODS
It is a prospective, pre-post test without a control group study. CBF flow paremeters were measured with Doppler ultrasonography in one middle cerebral artery. Sixty preterm stable infants were assessed before and after 30 min KMC. CBF indices were assessed in different positions before KMC, forty neonates in supine position and 20 in vertical suspension (baby is held vertically away from the skin of his mother). Other dependent variables heart rate and mean arterial blood pressure and Spo2 were also studied before and after KMC.


RESULTS
The mean gestational age of the infants was (32 ± 2 weeks), and mean birth weight was (2080 ± 270 gm). Comparing CBF indices (Pulsatility index and Resistive index) before and after KMC has shown a significant decrease in both Pulsatility index (PI) and Resistive index (RI) after 30 min. KMC, the mean values were (2.0 ± 0.43 vs 1.68 ± 0.33 & 0.81 ± 0.05 vs 0.76 ± 0.06 respectively P < 0.05*) with mean difference (0.32 & 95% CI 0.042-0.41 & 0.05 & 95% CI 0.04 to 0.06 respectively P < 0.05*) and increase in end diastolic velocity & mean velocity 30 min of KMC (10.97 ± 4.63 vs. 15.39 ± 5.66 P < 0.05*& 25.66 ± 10.74 vs. 32.86 ± 11.47 P < 0.05* ) with mean difference (- 4.42 & 95% CI -5.67 to -3.18 and -7.21 & 95% CI - 9.41 to 5.00 respectively). These changes indicate improvement in CBF. No correlation has been found between CBF parameters and studied vital signs or SpO2.


CONCLUSIONS
Kangaroo mother care improves cerebral blood flow, thus it might influence the structure and promote development of the premature infant's brain.
Pediatrics department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. afaf_korraa@yahoo.com.
Afaf A
AA
Korraa
Radiology department, faculty of medicine, Al-Azhar University, Cairo, Egypt. alyaa_elnagger@hotmail.com.
Alyaa A I
AA
El Nagger
Pediatrics department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. ragaaabdelsalam@gmail.com.
Ragaa Abd El-Salam
RA
Mohamed
Pediatrics department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. gamela.days@yahoo.com.
Noha M
NM
Helmy
D001942:Breast Feeding / Q000379:methods; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D060127:Kangaroo-Mother Care Method / Q000379:methods*; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000502:physiology; D011446:Prospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*