A efetividade do método canguru no tempo de internação hospitalar dos recém-nascidos pré-termo e/ou cim baixo peso ao nascimento: uma revisão sistemática com metanálise

Abstract

Introduction: The Kangaroo Method was developed in 1978 by Rey and Martinez in Bogotá, Colombia, as a program promoting the early discharge of low birth weight (LBW), preterm (PT), or small for age gestational age (SGA) newborns. It was proposed to solve overcrowding, the lack of equipment, the lack or unpreparedness of professionals, and the high cross-infection rates. Objectives: To evaluate the effectiveness of the Kangaroo Method in decreasing the length of hospital stay of preterm or low birth weight newborns, provide neonatal health professionals and health service managers with evidence-based recommendations to support the implementation and strengthening of the Kangaroo Method in neonatology services, and develop a tool to measure the time of intervention for families of preterm or low weight babies and health staff. Methods: A systematic review with meta-analysis was performed, searching the Cochrane Library, PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Information System (LILACS), and SciELO databases. Randomized clinical trials were included with no time or language limits, using the Kangaroo Method as an intervention in newborn patients with gestational age below 37 weeks or birth weight below 2,500g, born in health facilities, compared to conventional care. The titles and abstracts for study eligibility were read by a pair of independent reviewers, and any conflict was resolved by consensus. The methodological quality was assessed by the Cochrane Risk of Bias 2 Collaboration Tool to assess the risk of bias in randomized clinical trials. Results: The search in the mentioned databases identified 864 citations. Full-text reading was performed in 174 studies, and twelve studies were selected for data extraction. The combination of data showed that the Kangaroo Method decreased hospital time compared to the group submitted to conventional care, with a statistically significant difference (MD -1.75, 95% CI: -3.22 to -0.28). The subgroup that performed the intervention for more than 6 hours daily showed no statistical difference for the outcome length of hospital stay in the group that adopted the Kangaroo Method compared to the group submitted to conventional care (MD -0.79, 95% CI: -2.52 to 0.90). The subgroup that performed the intervention for less than 6 hours daily showed that the Kangaroo Method decreased hospital time compared to the group submitted to conventional care, with a statistically significant difference (MD -4.66; 95% CI: -7.15 to -2.17). Developed products: Kangaroo-meter application for marking the Kangaroo Method’s intervention time for mothers of preterm or low birthweight newborns admitted to Neonatology Units. Conclusions: The Kangaroo Method is a safe and low-cost intervention that effectively decreases the length of hospital stay of preterm or low birthweight newborns.