Ghojazadeh Morteza, Hajebrahimi Sakineh, Pournaghi-Azar Fatemeh, Mohseni Mohammad, Derakhshani Naser, Azami-Aghdash Saber
Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran.
Dental and Periodental Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
Rev Recent Clin Trials. 2019;14(1):31-40. doi: 10.2174/1574887113666180924165844.
BACKGROUND & AIMS: Evaluating the effect of Kangaroo Mother Care (KMC) on breastfeeding success shows conflicting results. Regarding the importance of breastfeeding and uncertainties about its effect, this study intended to conduct a systematic review and meta-analysis of randomised controlled trials on the effect of KMC on success of breastfeeding.
In this systematic review and meta-analysis study, required data were collected by searching the following keywords: breastfeeding, Breast-Feeding, "skin-to-skin", "Kangaroo Mother Care", randomized clinical trial. The following databases were searched: Google Scholar, PubMed, EMBASE, Scopus, and Cochrane Central Register of Controlled Trials. Two authors independently extracted the data. To estimate the Breast-Feeding outcome variables, CMA2 software was used. The risk of bias of studies was assessed with the criteria developed in the Cochrane Handbook.
Twenty articles were included. In the KMC and CNC groups, 1,432 and 1,410 neonates were examined. Breastfeeding success rate was higher in the KMC group within different time slots, however this difference was not statistically significant (RR=1.11(95CI, 0.93-1.34) and RR=1.13(95%CI, 0.92-1.34) based on the time slot and birth weight, respectively). The inter-groups differences in the mean scores of Infant Breast-Feeding Assessment Tool (IBFAT) were statistically significant (P<0.05). Breastfeeding was initiated very sooner in the KMC group, suggesting a statistically significant inter-groups difference -0.72(95%CI, from -0.92 to -0.53) (P<0.05). Majority of the studies had a high risk of bias.
Findings indicated a superiority of KMC over CNC in terms of breastfeeding success. Assessment of the complications and costs of KMC implementation is recommended.
评估袋鼠式护理(KMC)对母乳喂养成功的影响,结果存在冲突。鉴于母乳喂养的重要性及其效果的不确定性,本研究旨在对关于KMC对母乳喂养成功影响的随机对照试验进行系统评价和荟萃分析。
在这项系统评价和荟萃分析研究中,通过搜索以下关键词收集所需数据:母乳喂养、“肌肤接触”、“袋鼠式护理”、随机临床试验。搜索了以下数据库:谷歌学术、PubMed、EMBASE、Scopus和Cochrane对照试验中央注册库。两位作者独立提取数据。使用CMA2软件估计母乳喂养结果变量。根据Cochrane手册制定的标准评估研究的偏倚风险。
纳入20篇文章。在KMC组和常规护理组(CNC)中,分别对1432例和1410例新生儿进行了检查。在不同时间段内,KMC组的母乳喂养成功率较高,但差异无统计学意义(根据时间段和出生体重,相对危险度(RR)分别为1.11(95%置信区间(CI),0.93 - 1.34)和1.13(95%CI,0.92 - 1.34))。婴儿母乳喂养评估工具(IBFAT)平均得分的组间差异具有统计学意义(P<0.05)。KMC组更早开始母乳喂养,提示组间差异具有统计学意义,为 - 0.72(95%CI,从 - 0.92至 - 0.53)(P<0.05)。大多数研究存在较高的偏倚风险。
研究结果表明,在母乳喂养成功方面,KMC优于常规护理。建议评估实施KMC的并发症和成本。