Effect of Kangaroo Mother Care on Energy Utilization in Preterm Neonates

This study aims to assess the impact of kangaroo mother care on energy utilization in preterm neonates by measuring urinary levels of xanthine, uric acid, and malondialdehyde. It also aims to evaluate the effect of kangaroo mother care on physiological stress parameters in preterm neonates, as well as maternal emotional status

This randomized controlled clinical trial aims to evaluate the effect of kangaroo mother care on energy utilization and oxidative stress in preterm neonates admitted to the neonatal intensive care unit (NICU) at Ain Shams University Children's Hospital, Cairo, Egypt. Preterm neonates with gestational age between 32 and 36 weeks who meet the eligibility criteria will be enrolled and randomly assigned into two groups: an intervention group receiving kangaroo mother care and a control group receiving routine incubator care. All enrolled neonates will receive routine incubator care until day 3 of life. On day 3, the intervention group will receive one hour of kangaroo mother care provided by the mother after feeding, while the control group will receive one hour of standard nursing care without kangaroo mother care. Physiological parameters, including heart rate, respiratory rate, oxygen saturation, and temperature, will be monitored at baseline and every 15 minutes during the intervention period. Urine samples will be collected from neonates 3 hours before and 3 hours after the intervention to measure biomarkers of energy utilization (xanthine and uric acid) and oxidative stress (malondialdehyde) using ELISA kits. Maternal emotional status will be assessed using the Arabic version of the Depression Anxiety Stress Scale (DASS-21) before and after the intervention period. The study is conducted following approval from the Research Ethics Committee of Ain Shams University, and informed consent will be obtained from parents or legal guardians prior to participation.

Inclusion Criteria: * Preterm neonates (32-36 weeks) * Vitally stable * On room air or low ventilatory support Exclusion Criteria: * Neonates requiring surgery * Intraventricular hemorrhage * Receiving sedatives (morphine, fentanyl, midazolam) * Renal impairment * Congenital anomalies * Cyanotic heart disease * Severe respiratory distress * Hemodynamic instability * Hypothermia * Parental refusal