NCT06545760

Brief Summary

The goal of this clinical trial is to learn if extended admission to the Kangaroo Mother Care (KMC) ward helps to prevent postpartum depression in mothers of low birthweight infants in a low-resource setting whose newborns were admitted to the neonatal intensive care unit (NICU) more than standard of care KMC. The main questions it aims to answer are:

  • Does longer KMC decrease the incidence of postpartum depression in mothers of low birthweight infants in a low-resource setting?
  • Does longer KMC improve neurodevelopmental outcomes of low birthweight infants at 6, 12, and 18 months in a low-resource setting?
  • What are the barriers to practicing KMC in low birthweight infants following hospital discharge in a low-resource setting?
  • What is the prevalence of paternal depression in a low resource setting?
  • Is it cost effective to admit preterm mother-infant dyads to the KMC ward following NICU discharge? Researchers will compare (extended admission to the KMC ward) to (standard of care KMC) to see if extended KMC decreases PPD in mothers of preterm infants in low-resource settings. Participants (infants) will:
  • At time of discharge from the NICU, when clinically stable, spend either \< 2 days in the KMC ward with their mothers or spend longer in the KMC ward until discharge.
  • Return to clinic at routine follow-up visits (at 2 weeks and at 6-8 weeks) where mothers will be screened for postpartum depression and fathers will be screened for depression.
  • Return to clinic for neurodevelopmental screening at 6, 12, and 18 months where mothers will be screened for postpartum depression and perceived social support and fathers will be screened for depression.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,908

participants targeted

Target at P75+ for not_applicable

Timeline
17mo left

Started Dec 2024

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress51%
Dec 2024Sep 2027

First Submitted

Initial submission to the registry

August 1, 2024

Completed
8 days until next milestone

First Posted

Study publicly available on registry

August 9, 2024

Completed
4 months until next milestone

Study Start

First participant enrolled

December 1, 2024

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2026

Expected
1.3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2027

Last Updated

April 22, 2026

Status Verified

April 1, 2026

Enrollment Period

1.6 years

First QC Date

August 1, 2024

Last Update Submit

April 17, 2026

Conditions

Keywords

Low resource settingKangaroo Mother CarePaternal depressionCost-effectiveness

Outcome Measures

Primary Outcomes (1)

  • Percentage of Mothers with Postpartum Depression (PPD)

    Score on Edinburgh Postnatal Depression Scale (EPDS) screening tool obtained by interview with mother. This screening tool is a 10-question tool validated for use among pregnant women in low resource countries. It can be used for screening of perinatal depression, beginning from antenatal period up to 6-8 weeks postnatal age. Each question is scored between 0-3, the highest cumulative score being 30. Cut-off score for mothers with suspected postpartum depression (PPD) will be 11. All mothers who screen 11+ will be categorized to have PPD, all mothers scoring below 11 will be categorized as negative for PPD.

    8 weeks

Secondary Outcomes (30)

  • Percentage of Mothers with Postpartum Depression (PPD)

    2 weeks, 6 months, 12 months

  • Hours spent practicing Kangaroo Mother Care (KMC) in the neonatal intensive care unit (NICU)

    2 weeks

  • Hours spent practicing Kangaroo Mother Care (KMC) in the KMC Ward

    2 weeks

  • Hours spent practicing Kangaroo Mother Care (KMC) at home

    2 weeks, 8 weeks, 6 months, 12 months

  • Time of initiation of breastfeeding

    2 weeks

  • +25 more secondary outcomes

Study Arms (2)

Admission to Kangaroo Mother Care (KMC) ward for > 2 days after discharge from NICU

EXPERIMENTAL

Following discharge from the neonatal intensive care unit (NICU), preterm mothers and their infants will be discharged to an inpatient kangaroo mother care (KMC) ward for greater than 2 days for continued support.

Behavioral: Kangaroo mother care (KMC) support for > 2 days

Admission to Kangaroo Mother Care (KMC) ward for < 2 days after discharge from NICU

PLACEBO COMPARATOR

Following discharge from the neonatal intensive care unit (NICU), preterm mothers and their infants will be discharged to an inpatient kangaroo mother care (KMC) ward for less than 2 days for continued support.

Behavioral: Kangaroo mother care (KMC) support for < 2 days

Interventions

Admission to the kangaroo mother care (KMC) ward with continued support of kangaroo mother care, breastfeeding, and preterm infant care for less than 2 days prior to discharge home

Also known as: Routine kangaroo mother care (KMC)
Admission to Kangaroo Mother Care (KMC) ward for < 2 days after discharge from NICU

Eligibility Criteria

Age1 Day - 89 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • AIM #1-2 and #5
  • Mothers to newborns who are:
  • \) Birthweight between 1000-2000gm 2) Admitted to the Women and Neonates Hospital-University Teaching Hospital Neonatal Intensive Care Unit (WNH-UTH NICU) (\>48hrs) 3) Stable preterm eligible for continuing kangaroo mother care (KMC) in the NICU or NICU discharge 4) 16+ years of age (Mother) 5) Residing within Lusaka Province with no intensions to relocate in the coming 18 months
  • AIM #3
  • Parents (mothers and fathers) whose newborn has been enrolled in the study
  • Trusted family member or friend of the mother whose newborns is enrolled into the study
  • + years of age (mothers and fathers)
  • + years of age (family members)
  • AIM # 4:
  • Fathers whose newborn has been enrolled into the study
  • + years of age (father)

You may not qualify if:

  • AIM #1-2 and #5
  • Mothers who are on treatment for depression and/or anxiety
  • Mothers who did not consent
  • Underage mothers (16-17 years of age) whose parent(s) has not provided consent for their participation in the study
  • AIM #3
  • \) Family members of parents who do not consent to study participation
  • AIM # 4:
  • Fathers who are on treatment for depression and/or anxiety
  • Fathers who did not provide informed consent
  • Underage fathers (16-17 years of age) whose parent(s) has not provided consent for their participation in the study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Women and Newborn Hospital - University Teaching Hospitals

Lusaka, 10101, Zambia

RECRUITING

MeSH Terms

Conditions

Depression, PostpartumPremature Birth

Interventions

Kangaroo-Mother Care MethodPalliative Care

Condition Hierarchy (Ancestors)

Puerperal DisordersPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesDepressive DisorderMood DisordersMental DisordersObstetric Labor, PrematureObstetric Labor Complications

Intervention Hierarchy (Ancestors)

Patient PositioningPatient CareTherapeuticsInfant CareChild CareHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Albert Manasyan, MD, MPH

    Centre for Infectious Disease Research in Zambia

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Albert Manasyan, MD, MPH

CONTACT

J.Anitha Menon, MA, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

August 1, 2024

First Posted

August 9, 2024

Study Start

December 1, 2024

Primary Completion (Estimated)

June 30, 2026

Study Completion (Estimated)

September 30, 2027

Last Updated

April 22, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will share

De-identified individual participant data underlying the results reported in the primary publication, including maternal, paternal, and infant demographic characteristics, baseline maternal and paternal psychosocial variables, validated postpartum depression assessment scores, randomized intervention allocation, follow-up maternal and paternal mental health outcomes, relevant neonatal clinical variables collected as part of the study, and neurodevelopmental screening data of the infant. All direct identifiers will be removed. Indirect identifiers will be coded or aggregated to minimize re-identification risk in accordance with ethical and regulatory requirements in Zambia.

Shared Documents
STUDY PROTOCOL, ICF, CSR, ANALYTIC CODE
Time Frame
Data will be made available beginning 12 months following publication of the primary study results and will remain available for up to 5 years after publication.
Access Criteria
Data will be available to qualified researchers who submit a scientifically sound research proposal consistent with the objectives of the original study and compliant with ethical standards. Access will require: 1. Approval by the study's Data Access Committee 2. Evidence of ethics approval from the requestor's institution 3. Execution of a Data Use Agreement 4. Agreement not to attempt participant re-identification 5. Compliance with applicable Zambian data protection regulations and institutional policies Data will be shared through a secure data transfer platform or controlled-access repository.

Locations