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Assessment of maternal sleep quality in the phases of Kangaroo Mother Care Method


The Kangaroo-Mother Care (KMC) is a method of care for premature infants. It’s developed in three stages: the first in prenatal care and Neonatal Intensive Care Unit; the second at the Kangaroo Intermediate Care Unit (KICU); and the third in an outpatient clinic. There is a scientific gap in the studies of maternal sleep quality in the second and third stages of the KMC. Sleep quality is important because it can affect maternal emotional regulation and mother-child attachment.


This study aimed to evaluate the maternal sleep quality as well as the estimated total sleep duration and sleep efficiency, comparing three stages of the KMC method, more specifically: thirty days before partus, during one week in the KICU and the thirty days after hospital discharge.


This longitudinal study was approved by the Ethics Committee (CAAE:23716919.6.0000.5537). The Pittsburgh Sleep Quality Index (PSQI) was applied with 39 mothers to assess sleep quality in the first stage, with 22 in the second stage and with 10 in third, from January to August 2021, at a public maternity hospital. The age ranged from 19 to 42 years. Mothers with psychiatric and neurological disorders were excluded.


The median scores of the PSQI obtained were 7 in the first stage; 10 in the second; and 6 in the third, respectively, indicating poor sleep quality in the three moments. However, with higher impairment in the second stage. In order to assess whether there are differences in the PSQI components, we analyzed the estimated duration and sleep efficiency. Respectively, the medians indicated that the mothers in the study slept 7 hours/night, with a sleep efficiency of 86.9% in the first stage; 3 hours/night, and 54.2% of efficiency in the second stage and 6 hours/night, and 76% of sleep efficiency in the third stage. Comparing the three stages, the Friedman test showed that there were no statistical differences in the medians of the PSQI (p>0.05), but that there is a significant difference in estimated sleep duration (p=0.017) and sleep efficiency (p=0.017), indicating that mothers present variable sleep duration and efficiency at each stage of the KMC, showing that each stage influences these aspects.


The mothers experienced poor sleep quality and insufficient sleep quantity and efficiency in the three stages of the KMC method, especially in the second stage, which is indicative of highest sleep impairment.


Sleep; Kangaroo-Mother Care Method; Mothers; Mental Health; Infant, Premature


Área Clínica


Universidade Federal do Rio Grande do Norte - Rio Grande do Norte - Brasil


Larissa Maiara Fernandes de Morais, Ralina Carla Lopes Martins da Silva, Lucas Dantas Lima, Katie Moraes de Almondes