# “Short-term effects of a single kangaroo mother care session on urinary allantoin and maternal–infant bonding in preterm neonates: a quasi-randomized controlled trial”

## TL;DR

A single hour of skin-to-skin contact (Kangaroo Mother Care) in preterm infants reduces oxidative stress and improves maternal bonding within an hour.

## Contribution

This study demonstrates that even a brief KMC session can rapidly reduce oxidative stress and enhance maternal-infant bonding in preterm neonates.

## Key findings

- KMC significantly reduced urinary allantoin levels, indicating lower oxidative stress.
- KMC improved maternal-infant bonding scores significantly within one hour.
- The effects were observed in a single session, suggesting KMC as an acute physiological and psychological stabilizer.

## Abstract

Preterm birth is a leading contributor to neonatal morbidity and mortality, often necessitating neonatal intensive care unit (NICU) admission. The resulting separation of mother-infant dyads may escalate physiological stress and impair early bonding. While Kangaroo Mother Care (KMC) is a well-established intervention, evidence regarding the immediate physiological and affective impact of an isolated, short-duration session remains sparse. Thus, this study aimed to evaluate the short-term effects of a single one-hour KMC session on oxidative stress and maternal–infant bonding in preterm neonates. This quasi-randomized controlled trial was conducted at a tertiary care facility in Lahore, Pakistan (February–July 2024). Forty preterm neonate–mother dyads were allocated based on medical record numbers to receive either a single 60 minute KMC session (n = 20) or standard incubator care (n = 20). Primary and secondary outcomes included urinary allantoin (measured via ELISA) and Mother–Infant Bonding Scale (MIBS) scores, respectively, assessed at baseline and one hour after the intervention. Data were analysed using paired t-tests and analysis of covariance (ANCOVA). Baseline groups were comparable (p>0.05). Post-intervention, KMC significantly reduced allantoin levels compared to controls (Adjusted Mean Difference [AMD]: −26.18 µmol/mmol; 95% CI: -36.88 to −15.48; p<0.001; partial η2 =0.399). MIBS scores also improved significantly in the KMC group (AMD: −13.99; 95% CI: −14.84 to −13.14; p<0.001; partial η2 =0.967). A single one-hour session of Kangaroo Mother Care is associated with reduction in oxidative stress biomarkers and a significant short-term improvement in maternal–infant bonding. These findings suggest that even brief sessions of skin-to-skin contact may serve as potentially effective acute physiological and psychological stabilizer in the NICU setting. However, these immediate effects should be viewed as acute triggers rather than definitive markers of long-term clinical or developmental outcomes.

Trial registration: ClinicalTrials.gov, NCT 06338410. Registered 29 March 2024, https://clinicaltrials.gov/study/NCT06338410.