Impact of Kangaroo Mother Care on oxygen saturation histogram profiles among preterm infants: A prospective comparative study

Background Preterm infants often experience oxygen saturation (SpO 2 ) instability due to immature respiratory control. While Kangaroo Mother Care (KMC) is known to improve cardiorespiratory stability, its impact on detailed SpO 2 dynamics using histogram analysis has not been well studied. Methods In this prospective observational study, 120 paired sessions of KMC and off-KMC were analyzed in preterm infants (26 + 0 to 32 + 6 weeks gestation) admitted to a tertiary neonatal unit. Each session involved continuous SpO 2 monitoring using Masimo Radical-7 oximeters. The primary outcome was the percentage of time with SpO 2 ≤90%. Secondary outcomes included subgroup analyses by postmenstrual age (PMA) and respiratory support status. Results Infants spent less time with SpO 2 ≤90% during KMC (median 10%, IQR: 7–17) compared to off-KMC (12%, IQR: 8–18), although not statistically significant ( p = 0.06). A significant reduction was noted in infants on room air (median 9% vs 11%; p = 0.01). No significant difference was observed in those on CPAP, HFNC, or NIPPV. Infants with PMA >34 weeks showed an improvement in histogram trend during KMC, which was not statistically significant ( p = 0.06). Conclusions Overall, KMC showed a trend towards improved oxygen saturation patterns, although this was not statistically significant. Among stable preterm infants on room air without respiratory support, KMC was associated with a significant improvement.