Meta-analysis shows early kangaroo care reduces mortality in very preterm infants compared to conventional careEarly skin-to-skin contact may lower death risk for very preterm babies

Journal of perinatal medicine Published May 26, 2026 Study authors: Martins Joana Arêde, Ferreira-da-Silva Renato, Assunção André, Clemente Fátima, Azevedo Inês, Costa … PubMed ↗ DOI ↗ Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

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Key Takeaway

Consider early kangaroo care for very preterm infants as it may reduce mortality risk based on pooled RCT data.

This systematic review and meta-analysis examined the effects of early kangaroo care initiated within the first 24 hours compared to conventional neonatal care. The analysis pooled data from four randomized controlled trials involving 1,679 newborns classified as very preterm (≤32 weeks) and/or very low birth weight (<1,500 g). The primary focus was on mortality, infection risk, and hypothermia, though the specific primary outcome was not reported in the abstract.

Results indicated a significant reduction in mortality risk, with a relative risk of 0.81 and a 95% confidence interval of 0.67-0.98. For infection risk, the pooled relative risk was 0.89 (95% CI: 0.77-1.02), representing a reduction that was not statistically significant. Regarding hypothermia, the impact was mixed, and moderate heterogeneity was observed among the included studies. No specific adverse events, serious adverse events, or discontinuations were reported.

The authors acknowledge limitations including the inclusion of only four RCTs and the lack of data for infants <1,000 g or those born before 28 weeks. They caution that causality is not proven by this review alone and that findings should not be extrapolated to populations outside the studied gestational or weight ranges. Further studies are required to address these gaps.

Very preterm infants and those with very low birth weight face serious risks in the first days of life. A new analysis looked at whether starting skin-to-skin contact early could help. This practice involves placing the baby directly on a parent or caregiver chest. The team combined results from four trials involving 1,679 newborns.

The analysis showed a significant drop in death risk for babies who received this early care. Infection risk also showed a reduction trend, but the data did not reach a definitive conclusion on that point. Temperature stability, or hypothermia, showed mixed results across the different studies included.

The researchers noted that only four trials were available for this specific question. They also warned that the findings might not apply to the smallest babies born before 28 weeks or those weighing under 1,000 grams. More studies are needed to confirm these results for the most fragile infants.

What this means for you:

Early skin-to-skin care may reduce death risk for very preterm infants, but effects on temperature vary.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

PMID41762678

View Original Abstract ↓

OBJECTIVES: Kangaroo care (KC), involving skin-to-skin contact, early breastfeeding and early discharge, demonstrated benefits in improving outcomes for preterm and low birth weight infants. This systematic review and meta-analysis aimed to evaluate the effectiveness of early KC (initiated within the first 24 h) vs. conventional neonatal care in very preterm infants (≤32 weeks) and/or very low birth weight (VLBW) infants (<1,500 g). METHODS: A comprehensive search of MEDLINE, SCOPUS, Web of Science, and CENTRAL databases was conducted. Randomized controlled trials (RCTs) comparing early KC to conventional care in very preterm and/or VLBW infants were included. Risk of bias was assessed using the . Meta-analysis was conducted using R, with relative risks (RR) and 95 % confidence intervals (CI) calculated. RESULTS: Four RCTs, encompassing 1,679 newborns, were included. Meta-analysis revealed a significant reduction in mortality risk (RR=0.81, 95 % CI: 0.67-0.98) with early KC. The pooled RR for infection risk was 0.89 (95 % CI: 0.77-1.02). The impact on hypothermia was mixed, with moderate heterogeneity observed. CONCLUSIONS: Early KC may reduce mortality and morbidity in very preterm and VLBW infants although its effects on hypothermia vary by severity. Further studies are required to assess its effects on infants weighing <1,000 g or born before 28 weeks of gestation.

Meta-analysis shows early kangaroo care reduces mortality in very preterm infants compared to conventional careEarly skin-to-skin contact may lower death risk for very preterm babies

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