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Neonatal Follow-up

NICU Follow Up and Neurodevelopment 5: Impact of Parents and Social Determinants of Health

157 - Inpatient Kangaroo Care Predicts Early Cognitive Development at 6 and 12 Months Old in Infants Born Very Preterm

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 157
Publication Number: 157.363

Molly F.. Lazarus, Stanford University School of Medicine, Menlo Park, CA, United States; Virginia A. Marchman, Stanford University School of Medicine, Stanford, CA, United States; Edith Brignoni Perez, Stanford University School of Medicine, Stanford, CA, United States; Sarah Dubner, Stanford University School of Medicine, Santa Cruz, CA, United States; Heidi M. Feldman, Stanford University School of Medicine, Palo Alto, CA, United States; Melissa Scala, Stanford University School of Medicine, Palo Alto, CA, United States; Katherine Travis, Stanford University School of Medicine, Palo Alto, CA, United States

Presenting Author(s)

Molly F. Lazarus (she/her/hers)

Clinical Research Coordinator
Stanford University School of Medicine
Menlo Park, California, United States

Background: Kangaroo Care (KC), or skin-to-skin care, is a developmental care method associated with short-term health outcomes for preterm infants. Children born very preterm (VPT: < 32 weeks gestational age (GA)) are at-risk for adverse neurodevelopmental outcomes in multiple cognitive domains. Limited direct evidence links hospital-based experiences of KC to long-term neurodevelopmental outcomes in VPT children.

Objective: The present study investigated relations between inpatient KC and non-verbal cognitive abilities measured at 6 and 12 months age (adjusted for prematurity).

Design/Methods:

We performed a retrospective cohort study of VPT infants (6-month N=77, 12-month N=37, Table 1). Daily minutes of family-administered KC and visitation were derived from the electronic medical record (EMR) and frequencies during hospitalization (instances/days of hospitalization) were computed. Early cognitive development, expressed as age-adjusted 6- and 12-month Cognitive-Adaptive Test (CAT) scores from the Capute Scales, were collected as part of routine High-Risk Infant Follow Up visits.

Results: Hierarchical linear regression modeling showed that KC uniquely predicted 6-month CAT scores over and above GA, SES, health acuity, and visitation (full model: F=2.44, p</em>=0.042, r²=0.15; KC r² change=0.07, p=0.017, Figure 1). KC also predicted CAT scores at 12 months over and above birth GA, SES, health acuity, and 6-month CAT score (full model: F=4.77, p=0.002, r²=0.44; KC r² change=0.09, p=0.030, Figure 2). Health acuity score moderated the relation between KC and CAT at 6 months (full model: F=3.79, p=0.004, r²=0.21; interaction r² change=0.07, p=0.016) but not 12 months (full model: F=3.85, p=0.006, r²=0.44; interaction r² change< 0.001, p=0.979); associations at 6 months were significant only among sicker children but were present across the entire sample by 12 months.

Conclusion(s): VPT infants who experienced more KC during hospitalization demonstrated higher scores on 6- and 12-month assessments of cognitive development. These positive associations demonstrate that KC uniquely contributes to neurodevelopmental outcomes in VPT infants over and above other common sociodemographic and clinical factors. Critically, KC was beneficial independent of infants’ health acuity at 12 months. Together, these results provide strong evident that KC has significant potential as a long-term neuroprotective clinical strategy for all VPT infants.