Systematic review and meta‐analysis suggest that Kangaroo position protects against apnoea of prematurity

Abstract

The aim of this study was to determine whether the Kangaroo position decreased apnoea events in preterm newborns compared with conventional care in incubator. We conducted a systematic review of clinical trials published in English, French, Spanish and Portuguese. A comprehensive literature search was realised until 2017. The main outcome was apnoea events. Data were extracted and combined in a fixed-effects model. The quality of the evidence was assessed according to the GRADE framework (grading the quality of evidence and the strength of recommendations). Four original clinical trials were selected. These trials were conducted in India and Nepal, between 2005 and 2016. The systematic review comprised 416 preterm newborns. Three studies were randomised controlled trials and one was quasi-experimental. Meta-analysis showed a statistically significant reduction in apnoea episodes (relative risk [RR] 0.41; 95% confidence interval [CI] 0.22, 0.78). The result remained significant when only the three clinical trials were analysed (RR 0.43; 95% CI 0.23, 0.83). Quality analysis indicated moderate quality because of lack of an appropriate method of randomisation in one study. The Kangaroo position could have protective effect against apnoea events in preterm infants, decreasing the associated risk of death or long-term disability.