Indian journal of pediatrics · 2026
Effect of Kangaroo Mother Care on Cerebral Blood Flow of Clinically Unstable Preterm Neonates.
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Shah Sonam, Subhadarsini Santoshi, Nanavati Ruchi, Haribalakrishna Anitha
Аннотация
OBJECTIVE: Kangaroo Mother Care (KMC) has emerged as a potent neuroprotective intervention for preterm infants, demonstrating significant benefits in cerebral maturation and cardiorespiratory stability. Although its role in enhancing cerebral hemodynamics among hemodynamically stable neonates is well established, evidence regarding its effects in clinically unstable preterm infants remains scarce. Therefore, the authors designed this study to evaluate the impact of KMC on cerebral blood flow (CBF) in clinically unstable preterm neonates using transcranial Doppler ultrasonography.
METHODS: This single-centre prospective observational study was conducted in a tertiary-level NICU in Western India. Thirty preterm infants (28-36⁶⁄₇ wk; 1000-1500 g) with hemodynamic instability were enrolled. Middle cerebral artery (MCA) Doppler parameters-peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (MV), resistive index (RI), and pulsatility index (PI)-were recorded at baseline, after 60 min of KMC, and 60 min post-KMC. Heart rate, respiratory rate, and oxygen saturation were simultaneously monitored.
RESULTS: Significant increases were observed in PSV [p = 0.0005], EDV [p = 0.04], and MV [p = 0.007] at 60 min after KMC, with sustained elevations in PSV and MV post-intervention. RI and PI showed no significant change. KMC also improved physiological stability, reflected by optimal HR, RR, and SpO2.
CONCLUSIONS: KMC significantly improved middle cerebral artery flow velocities in hemodynamically unstable preterm infants, suggesting a potential neuromodulatory and neuroprotective role. Larger multicentre studies are needed to confirm these findings and assess long-term outcomes.
METHODS: This single-centre prospective observational study was conducted in a tertiary-level NICU in Western India. Thirty preterm infants (28-36⁶⁄₇ wk; 1000-1500 g) with hemodynamic instability were enrolled. Middle cerebral artery (MCA) Doppler parameters-peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (MV), resistive index (RI), and pulsatility index (PI)-were recorded at baseline, after 60 min of KMC, and 60 min post-KMC. Heart rate, respiratory rate, and oxygen saturation were simultaneously monitored.
RESULTS: Significant increases were observed in PSV [p = 0.0005], EDV [p = 0.04], and MV [p = 0.007] at 60 min after KMC, with sustained elevations in PSV and MV post-intervention. RI and PI showed no significant change. KMC also improved physiological stability, reflected by optimal HR, RR, and SpO2.
CONCLUSIONS: KMC significantly improved middle cerebral artery flow velocities in hemodynamically unstable preterm infants, suggesting a potential neuromodulatory and neuroprotective role. Larger multicentre studies are needed to confirm these findings and assess long-term outcomes.