Impact of Kangaroo Mother Care on Cerebral Hemodynamics in Stable Preterm Neonates: A Prospective Interventional Study

Abstract Background: Preterm neonates are vulnerable to brain injury due to immature cerebral autoregulation and fluctuating cerebral blood flow (CBF). Kangaroo mother care (KMC) has emerged as a potential neuroprotective intervention beyond its established benefits in thermoregulation and growth. Objective: The objective of this study was to evaluate the effect of KMC on cerebral hemodynamics in stable preterm neonates using Transcranial Doppler Sonography (TCDS) of the middle cerebral artery (MCA). Materials and Methods: This prospective interventional study was conducted at a Level 3 neonatal intensive care unit from March 2023 to September 2024. Fifty-seven hemodynamically stable preterm neonates (28 0/7–36 6/7 weeks’ gestational age) underwent TCDS assessment of MCA parameters and physiological monitoring at three time points: pre-KMC, at 60 min of KMC, and 60 min after stopping KMC. CBF parameters, including peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV), resistive index (RI), and pulsatility index (PI), were measured alongside vital signs. Results: The study included 31 males (54.4%) and 26 females (45.6%) with a mean gestational age of 34.03 ± 2.67 weeks and birth weight of 1.87 ± 0.50 kg. During KMC, significant improvements were observed: PSV increased from 45.04 ± 2.26 to 46.78 ± 2.23 cm/s ( P < 0.0001), EDV from 11.05 ± 1.14 to 12.26 ± 1.15 cm/s ( P < 0.0001), and MV from 22.38 ± 1.49 to 23.77 ± 1.45 cm/s ( P < 0.0001). Resistance indices decreased significantly: RI from 0.76 ± 0.01 to 0.74 ± 0.02 ( P < 0.0001) and PI from 1.52 ± 0.06 to 1.46 ± 0.06 ( P < 0.0001). Heart rate decreased (147.81 ± 9.13–142.42 ± 7.71 bpm, P < 0.0001), whereas peripheral oxygen saturation increased (94.75 ± 2.35–96.00 ± 2.16%, P < 0.0001). Strong positive correlations were found between gestational age, birth weight, and cerebral flow parameters. Conclusions: KMC significantly improves cerebral hemodynamics in stable preterm neonates by enhancing CBF velocities and reducing vascular resistance. These findings support the integration of KMC as a neuroprotective strategy in neonatal intensive care, particularly in resource-limited settings.