title: Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care.
abstract: Kangaroo mother care (KMC) is a multifaceted intervention for preterm and low birth weight infants and their parents. Short- and mid-term benefits of KMC on survival, neurodevelopment, breastfeeding, and the quality of mother-infant bonding were documented in a randomized controlled trial (RCT) conducted in Colombia from 1993 to 1996. The aim of the present study was to evaluate the persistence of these results in young adulthood.
  
  
  
  From 2012 to 2014, a total of 494 (69%) of the 716 participants of the original RCT known to be alive were identified; 441 (62% of the participants in the original RCT) were re-enrolled, and results for the 264 participants weighing ≤1800 g at birth were analyzed. The KMC and control groups were compared for health status and neurologic, cognitive, and social functioning with the use of neuroimaging, neurophysiological, and behavioral tests.
  
  
  
  The effects of KMC at 1 year on IQ and home environment were still present 20 years later in the most fragile individuals, and KMC parents were more protective and nurturing, reflected by reduced school absenteeism and reduced hyperactivity, aggressiveness, externalization, and socio-deviant conduct of young adults. Neuroimaging showed larger volume of the left caudate nucleus in the KMC group.
  
  
  
  This study indicates that KMC had significant, long-lasting social and behavioral protective effects 20 years after the intervention. Coverage with this efficient and scientifically based health care intervention should be extended to the 18 million infants born each year who are candidates for the method.
authors.affiliation: Fundación Canguro, Bogotá, Colombia; ncharpak@gmail.com.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Charpak
authors.affiliation: Université Laval, Québec City, Québec, Canada.
authors.forename: Rejean
authors.initials: R
authors.lastname: Tessier
authors.affiliation: Pontificia Universidad Javeriana, Bogotá, Colombia.|Hospital Universitario San Ignacio, Bogotá, Colombia.
authors.forename: Juan G
authors.initials: JG
authors.lastname: Ruiz
authors.affiliation: Universidad de los Andes, Bogotá, Colombia.
authors.forename: Jose Tiberio
authors.initials: JT
authors.lastname: Hernandez
authors.affiliation: Pontificia Universidad Javeriana, Bogotá, Colombia.|Hospital Universitario San Ignacio, Bogotá, Colombia.
authors.forename: Felipe
authors.initials: F
authors.lastname: Uriza
authors.affiliation: Fundación Canguro, Bogotá, Colombia.
authors.forename: Julieta
authors.initials: J
authors.lastname: Villegas
authors.affiliation: Université Laval, Québec City, Québec, Canada.
authors.forename: Line
authors.initials: L
authors.lastname: Nadeau
authors.affiliation: Université Laval, Québec City, Québec, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Mercier
authors.affiliation: Hôpital St Justine, Montréal, Québec, Canada.
authors.forename: Francoise
authors.initials: F
authors.lastname: Maheu
authors.affiliation: Hospital Universitario Infantil San José, Bogotá, Colombia; and.
authors.forename: Jorge
authors.initials: J
authors.lastname: Marin
authors.affiliation: Universidad del Rosario, Bogotá, Colombia.
authors.forename: Darwin
authors.initials: D
authors.lastname: Cortes
authors.affiliation: Universidad del Rosario, Bogotá, Colombia.
authors.forename: Juan Miguel
authors.initials: JM
authors.lastname: Gallego
authors.affiliation: Universidad de los Andes, Bogotá, Colombia.
authors.forename: Dario
authors.initials: D
authors.lastname: Maldonado
mesh_terms: D000293:Adolescent; D001942:Breast Feeding; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000517:prevention & control; D002675:Child, Preschool; D003105:Colombia; D019955:Conduct Disorder / Q000453:epidemiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007360:Intelligence; D060127:Kangaroo-Mother Care Method / Q000639:trends*; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D065886:Neurodevelopmental Disorders / Q000453:epidemiology / Q000517:prevention & control; D009769:Object Attachment; D012917:Social Adjustment; D016019:Survival Analysis; D055815:Young Adult