IMPACT OF KANGAROO MOTHER CARE ON PRETERM NEONATAL OUTCOMES IN RESOURCE-LIMITED SETTINGS

Abstract

Preterm birth is the leading cause of neonatal morbidity and mortality globally, with the burden highest in resource-limited settings where advanced neonatal care is frequently limited. This study aims to evaluate the effect of KMC over conventional thermal care on preterm, low-birth-weight neonates between 28-34 weeks of gestation at JPMC, Karachi Pakistan. Globally, the literature indicates that KMC is a biologically plausible, low-cost, and feasible-to-scale intervention that has been proven to enhance survival, thermoregulation, and breastfeeding in low- and middle-income countries. Between January and December 2024, consecutive sampling will be used to enrol 1100 neonates (550 in the KMC group and 550 in the Conventional Care Group) in a prospective observational design. Method Maternal and neonatal characteristics, feeding practices, clinical outcomes, and 28-day survival were recorded in data abstraction forms. Statistical analyses were performed using SPSS version 26.0, applying chi-square tests, t-tests and multivariate regression. Significantly lower values for neonatal mortality were shown in the KMC versus the Conventional Care group (8.5% vs 14.9%, p = 0.002). Compared with standard care, KMC was also associated with a lower incidence of hypothermia (20.4% vs 34.3%, p < 0.01), fewer cases of culture-confirmed sepsis (7.5% vs 12.4%, p = 0.01), better rates of exclusive breastfeeding at discharge (75.8% vs 53.8%, p < 0.01), higher rates of daily weight gain (16.2 vs 13.8 g/kg/day, p < 0.01), and shorter lengths of stay (8.7 vs 10.5 days, p < 0.01). KMC was independently associated from other factors with mortality (OR 0.55), hypothermia (OR 0.52), and breastfeeding (OR 2.31), as multivariate analysis. These findings further establish KMC as an effective, context-relevant intervention with a high-impact on neonatal outcomes for preterm infants and provide a practical scalable solution for health and survival in resource-constrained hospitals.