Inpatient Kangaroo Care Predicts Early Cognitive Development at 6 and 12 Months in Infants Born Very Preterm

Abstract

AbstractBackgroundLimited research links hospital-based experiences of Kangaroo Care (KC), or skin-to-skin holding to longer-term neurodevelopmental outcomes in preterm children. The present study examined relations between inpatient KC and cognitive abilities measured at 6- and 12-months of age in a sample of very preterm (VPT) infants.MethodsRetrospective study reviewing medical records of 132 (54% male) VPT infants (<32 weeks gestational age (GA)). We calculated KC frequency (instances/day), KC rate (minutes/day), and KC duration (minutes/instance). Scores on the Cognitive-Adaptive Test were available as part of routine follow-up care at 6 (n=77) and 12 (n= 37) months.ResultsFamilies engaged in KC about 2 days/week, 20 minutes/day, and 70 minutes/session, on average, although there was substantial variability. Variation in KC was positively associated with cognitive outcomes at both 6 (frequency: r=0.32; rate: r=0.29) and 12 (frequency: r=0.53; rate: r=0.59; duration: r=0.38) months. KC significantly predicted 7 to 27% unique variance in 6- and 12-month cognitive outcomes, after controlling for GA, socioeconomic status, health acuity, visitation frequency, and prior cognitive scores. Small increases in KC frequency (e.g., 1 day/week), rate (e.g., 20 minutes/day) or duration (e.g., 20 minutes/instance) were associated with 0.5 to 1.0 SD increases in cognitive outcomes at 12 months. SES, GA, and infant health acuity did not moderate these relations.ConclusionVPT infants with more KC during hospitalization demonstrated higher scores on 6- and 12- month assessments of cognitive development. Results provide strong evidence that KC may confer neuroprotection on VPT infants through the first year of life.Article SummaryVariation in family-delivered Kangaroo Care in the NICU predicted infants’ higher cognitive performance at 6 and 12 months, beyond visitation, clinical, and demographic factors.What is Known on This SubjectKangaroo Care is a developmental care practice associated with positive short-term outcomes for preterm infants. Kangaroo Care is thought to mitigate adverse neurodevelopmental outcomes associated with preterm birth, but direct evidence of effects beyond hospital discharge is limited.What This Study addsIn this retrospective cohort study, frequency, amount, and duration of family-delivered Kangaroo Care in the NICU predicted cognitive abilities at 6 and 12 months. Kangaroo care may be a long-term neuroprotective clinical strategy for infants born preterm.