Immediate KMC in high-resource neonatal intensive care units
An untested question. Starting skin-to-skin care right after birth lowered deaths of small babies in the WHO iKMC trial, which ran in five hospitals in Africa and India. Would it also help small babies in well-equipped intensive care units? The trial's authors say this is not yet known.
- Idea
- In this atlas
Overview
Technical summary
Hypothesis, not a result. The iKMC authors write that further studies in well-resourced settings could help determine whether the survival results are relevant to low-mortality settings with intensive infant monitoring. No test in a high-resource unit is recorded in this atlas.
Hypothesis
Hypothesis, not a result. Nothing here has been demonstrated.
In high-resource neonatal intensive care units, starting continuous skin-to-skin care immediately after birth, before stabilization, would lower death or illness among infants of 1.0 to under 1.8 kg compared with starting it after stabilization.
- Maturity
- Concept
- Rationale
- The iKMC trial found fewer deaths with immediate KMC in five tertiary hospitals in Ghana, India, Malawi, Nigeria and Tanzania. Its authors say that relevance to low-mortality settings with intensive infant monitoring is not known.
- Proposed test
- A randomized comparison of immediate with after-stabilization KMC in a high-resource unit, in infants of 1.0 to under 1.8 kg. None is recorded here.
Objections
- The iKMC authors say the benefit cannot be split between immediate starting and the mother's continuous presence, because both are part of the intervention.
- High-resource units have intensive monitoring and a different level of mortality, so the low-resource result may not carry over.
Claims and evidence
Context Hypothetical: infants of 1.0 to under 1.8 kg in high-resource neonatal intensive care units
- Recipient
- Newborn
- Population
- A hypothetical population for an untested question: infants with a birth weight of 1.0 to under 1.8 kg, of any gestational age, cared for in high-resource neonatal intensive care units. The iKMC trial enrolled this weight band in five tertiary hospitals in Ghana, India, Malawi, Nigeria and Tanzania.
- Care setting
- High-resource neonatal intensive care units. Hypothetical: no result recorded in this atlas covers this setting.
- Geography
- Not stated; hypothetical
- Life stage
- Neonatal period
- Gestational age
- Not reported
- Postnatal age
- Not reported
- Follow-up
- Not applicable (hypothetical context)
Eligibility: 1 inclusion criterion; exclusion criteria not stated
- Included
- Birth weight 1.0 kg to under 1.8 kg
- Excluded
- None stated
Hypothesis, not a result: starting continuous skin-to-skin care immediately after birth might also lower deaths or illness among infants of 1.0 to under 1.8 kg in high-resource neonatal intensive care units. The iKMC trial that found fewer deaths ran in five tertiary hospitals in Ghana, India, Malawi, Nigeria and Tanzania, and its authors say further studies in well-resourced settings could help show whether the results apply to low-mortality settings with intensive infant monitoring.
Applies to Newborn- A hypothetical population for an untested question: infants with a birth weight of 1.0 to under 1.8 kg, of any gestational age, cared for in high-resource neonatal intensive care units. The iKMC trial enrolled this weight band in five tertiary hospitals in Ghana, India, Malawi, Nigeria and Tanzania.
- High-resource neonatal intensive care units. Hypothetical: no result recorded in this atlas covers this setting.
- Not stated; hypothetical
- Neonatal period
- Gestational age Not reported
- Postnatal age Not reported
- Certainty method
- Not assessed
- Limitations
- No test of immediate KMC in a high-resource unit is recorded in this atlas. The iKMC authors say the effect cannot be separated from the mother's continuous presence.
- Last checked
- Not recorded
- Next evidence check due
- Not scheduled
Sources and citations (2)
-
Background Immediate "Kangaroo Mother Care" and Survival of Infants with Low Birth Weight
- Locator
- Discussion, para 3
- How it applies
- The authors say applicability to low-mortality settings with intensive monitoring is untested.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac- Reuse basis
- Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.
-
Background Immediate "Kangaroo Mother Care" and Survival of Infants with Low Birth Weight
- Locator
- Discussion, para 5
- How it applies
- The effect of early starting cannot be separated from the mother's presence.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
0945a417a4ffacfded839e4e8df7cf03c99c581e34fbca8ddd6daa7229b79bac- Reuse basis
- Bibliographic metadata and short factual extraction. The PMC author accepted manuscript is licensed CC BY 4.0 and is committed at research/snapshots/pmc-PMC8108485.xml. Attribution: WHO Immediate KMC Study Group, N Engl J Med 2021;384:2028-2038, doi:10.1056/NEJMoa2026486, author accepted manuscript via PMC (PMC8108485). The version of record is not redistributed.
Record details
- Record id
maternal:idea-immediate-kmc-high-resource-nicu- Content hash
3bbe1e52f9dfe6839b40c80b9ab16c53e3e6c9c44bcd95b8c1ce09d8e6aca379