Impact of kangaroo mother care on maternal postpartum depression: a systematic review and meta-analysis of controlled trials
Kangaroo mother care was linked to lower depression symptom scores after childbirth, especially among mothers of preterm infants and in resource-limited settings.
*Systematic review and meta-analysis of controlled trials; Level 2a (OCEBM).
*Systematic review and meta-analysis of controlled trials; Level 2a (OCEBM).
Citation
Gujrathi S, ShreyaC, Hareesh S, Sudesh R, Ahmad F. Impact of kangaroo mother care on maternal postpartum depression: a systematic review and meta-analysis of controlled trials. Pediatric Research. 2026. doi:10.1038/s41390-026-05157-3.
Background
Postpartum depression can harm maternal functioning and infant development. Kangaroo mother care, based on prolonged skin-to-skin contact (often with breastfeeding), may support maternal mental health.
Patients
Postpartum women after term or preterm delivery (13 controlled trials; 892 total). Key exclusions at review level: studies without a control group, without pre- and post-intervention depression scores, or without validated depression measures.
Intervention
Kangaroo mother care (skin-to-skin mother–infant contact; session length often ~60 minutes, but variable).
Control
Standard care without kangaroo mother care (for example, incubator or routine postpartum care).
Outcome
Maternal depression symptom scores on validated questionnaires (for example, Edinburgh Postnatal Depression Scale, 0–30).
Follow-up Period
Varied; typically early post-intervention assessments (often within 2–4 weeks).
Results
Across 13 studies (439 intervention; 453 control), kangaroo mother care lowered depression symptom scores overall, with substantial between-study variability (heterogeneity I2=78%).
| Comparison | Change in depression symptom scores |
|---|---|
| Overall (primary outcome) | Standardized mean difference −0.58 (95% CI, −0.88 to −0.28) |
| Developed countries subgroup | Standardized mean difference −0.41 (95% CI, −0.63 to −0.19) |
| Developing countries subgroup | Standardized mean difference −0.83 (95% CI, −1.41 to −0.25) |
| Preterm birth subgroup | Standardized mean difference −0.65 (95% CI, −1.05 to −0.24) |
Standardized mean difference: negative values mean fewer symptoms; ~0.2 small, ~0.5 moderate, ~0.8 large difference.
Limitations
Effects varied widely across studies, and kangaroo mother care “dose” (setting, frequency, duration) was inconsistent. Most evidence involved preterm births; too few studies focused on full-term births to be confident for that group. Follow-up was usually short, so long-term benefit is unclear. Depression was measured with different questionnaires, making results harder to interpret for individual patients.
Funding
Not reported; funding-related bias cannot be assessed.
Clinical Application
Consider offering kangaroo mother care as a low-cost add-on—especially after preterm birth—while continuing standard depression screening and treatment when needed.
Discussion
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In this systematic review and random-effects meta-analysis of controlled trials, kangaroo mother care (KMC) was associated with lower postpartum depression symptom scores (SMD −0.58, 95% CI −0.88 to −0.28; I²=78%). How do heterogeneity and risk-of-bias concerns affect validity and whether you’d change postpartum/NICU practice? The meta-analysis reported an overall standardized mean difference (SMD) of −0.58 with a 95% CI of −0.88 to −0.28 for postpartum depression symptom scores (negative favors KMC). Which interpretation is most appropriate?