https://orcid.org/0000-0001-6886-5068
Dear editor
I have carefully reviewed the article entitled “Kangaroo Mother Care Induced Serum Oxytocin Facilitates Prolactin and IL-10 Among Emergency Cesarean Mothers” by Ramaiah et al.Citation1 While the study provides valuable insights into the hormonal and cytokine changes associated with Kangaroo Mother Care (KMC) practice in emergency cesarean section mothers, there are several limitations that should be addressed.
Firstly, the study lacks a clear description of the inclusion and exclusion criteria for the control group. It is essential to ensure that the control group is comparable to the KMC group in terms of maternal age, gestational age, and other relevant factors that may influence the hormonal and cytokine levels.Citation2 Additionally, the small sample size (16 in the KMC group and 9 in the control group) raises concerns about the statistical power and generalizability of the findings.
Secondly, while the authors acknowledge the limitation of obtaining serum samples at relatively long intervals, this could have affected the accuracy of the measurements, especially for short-lived hormones like oxytocin. More frequent sampling would have provided a better understanding of the kinetics of hormonal and cytokine changes.Citation3
Thirdly, the authors did not provide information on the potential confounding factors that could influence the hormonal and cytokine levels, such as maternal stress, pain, and medications used during the perioperative period.Citation4 These factors should be carefully controlled or accounted for in the analysis to ensure the validity of the results.
Fourthly, the study lacks a detailed description of the KMC protocol used, including the duration, frequency, and timing of the sessions. Standardization of the KMC protocol is crucial for replicability and comparison with other studies.Citation5
Finally, the authors did not assess the long-term effects of KMC on maternal and infant outcomes, such as breastfeeding duration, maternal mental health, and infant development.Citation6 Longitudinal studies are needed to understand the sustained benefits of KMC and its impact on various aspects of maternal and infant well-being.
Despite these limitations, the study provides valuable preliminary data on the potential benefits of KMC in emergency cesarean section mothers. Future well-designed, prospective studies with larger sample sizes, controlled confounding factors, and standardized KMC protocols are needed to substantiate the findings and further elucidate the mechanisms underlying the observed hormonal and cytokine changes.
Disclosure
The author reports no conflicts of interest in this communication.
References
- Ramaiah R, Jothishanmugam A, Alshahrani SH, et al. Kangaroo mother care induced serum oxytocin facilitates prolactin and IL-10 among emergency cesarean mothers. JMDH. 2024;17:2689–2699. doi:10.2147/JMDH.S444172
- Mörelius E, Örtenstrand A, Theodorsson E, Frostell A. A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding. Early Human Dev. 2015;91(1):63–70. doi:10.1016/j.earlhumdev.2014.12.005
- Qian Y, Bi HY. The effect of magnocellular-based visual-motor intervention on Chinese children with developmental dyslexia. Front Psychol. 2015;6:6. doi:10.3389/fpsyg.2015.01529
- Khasawneh W, Obeidat N, Yusef D, Alsulaiman JW. The impact of cesarean section on neonatal outcomes at a university-based tertiary hospital in Jordan. BMC Pregnancy Childbirth. 2020;20(1):335. doi:10.1186/s12884-020-03027-2
- Olawuyi O, Ezenwa BN, Fajolu IB, Onwuama M, Ezeaka CV. Knowledge, attitude and practice of kangaroo mother care among mothers in the neonatal wards of a tertiary care center. Pan Afr Med J. 2021;38:364. doi:10.11604/pamj.2021.38.364.22833
- Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2016;2016(8):CD002771. doi:10.1002/14651858.CD002771.pub4