title: Kangaroo Mother Care and Neonatal Outcomes: A Meta-analysis.
abstract: BACKGROUND
  Kangaroo mother care (KMC) is an intervention aimed at improving outcomes among preterm and low birth weight newborns.
  
  
  OBJECTIVE
  Conduct a systematic review and meta-analysis estimating the association between KMC and neonatal outcomes.
  
  
  METHODS
  PubMed, Embase, Web of Science, Scopus, African Index Medicus (AIM), Latin American and Caribbean Health Sciences Information System (LILACS), Index Medicus for the Eastern Mediterranean Region (IMEMR), Index Medicus for the South-East Asian Region (IMSEAR), and Western Pacific Region Index Medicus (WPRIM).
  
  
  METHODS
  We included randomized trials and observational studies through April 2014 examining the relationship between KMC and neonatal outcomes among infants of any birth weight or gestational age. Studies with <10 participants, lack of a comparison group without KMC, and those not reporting a quantitative association were excluded.
  
  
  METHODS
  Two reviewers extracted data on study design, risk of bias, KMC intervention, neonatal outcomes, relative risk (RR) or mean difference measures.
  
  
  RESULTS
  1035 studies were screened; 124 met inclusion criteria. Among LBW newborns, KMC compared to conventional care was associated with 36% lower mortality(RR 0.64; 95% [CI] 0.46, 0.89). KMC decreased risk of neonatal sepsis (RR 0.53, 95% CI 0.34, 0.83), hypothermia (RR 0.22; 95% CI 0.12, 0.41), hypoglycemia (RR 0.12; 95% CI 0.05, 0.32), and hospital readmission (RR 0.42; 95% CI 0.23, 0.76) and increased exclusive breastfeeding (RR 1.50; 95% CI 1.26, 1.78). Newborns receiving KMC had lower mean respiratory rate and pain measures, and higher oxygen saturation, temperature, and head circumference growth.
  
  
  CONCLUSIONS
  Lack of data on KMC limited the ability to assess dose-response.
  
  
  CONCLUSIONS
  Interventions to scale up KMC implementation are warranted.
authors.affiliation: Departments of Epidemiology, grace.chan@childrens.harvard.edu.
authors.forename: Ellen O
authors.initials: EO
authors.lastname: Boundy
authors.affiliation: Departments of Global Health and Population, and.
authors.forename: Roya
authors.initials: R
authors.lastname: Dastjerdi
authors.affiliation: Departments of Epidemiology, Departments of Global Health and Population, and Biostatistics, and.
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.affiliation: Departments of Epidemiology, Departments of Global Health and Population, and Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts;
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
authors.affiliation: Departments of Epidemiology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts;
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
authors.affiliation: Departments of Epidemiology, Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts;
authors.forename: Ellice
authors.initials: E
authors.lastname: Lieberman
authors.affiliation: Departments of Epidemiology.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Kajeepeta
authors.affiliation: Save the Children, Washington, DC; and.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wall
authors.affiliation: Departments of Global Health and Population, and Save the Children, Washington, DC; and Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Grace J
authors.initials: GJ
authors.lastname: Chan
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D060127:Kangaroo-Mother Care Method; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic