Impact of kangaroo mother care on maternal postpartum depression: a systematic review and meta-analysis of controlled trials

Background

Postpartum depression (PPD) is a debilitating condition with adverse consequences for mothers and infants. Kangaroo mother care (KMC), involving prolonged skin-to-skin contact often combined with breastfeeding, has been proposed as an alternative intervention for improving maternal mental health.

Methods

To examine the effect of KMC on PPD outcomes, scholarly databases, PubMed, and Google Scholar were searched for controlled trials published between 1998 and 2025 and reporting validated depression measures. Outcome measures in standardized mean differences (SMDs) were pooled using random-effects models. Publication quality was assessed with the Cochrane Risk of Bias tool or Newcastle-Ottawa scale.

Results

Thirteen studies comprising 439 mothers in KMC groups and 453 controls were included. KMC was associated with a significant reduction in depression symptoms (SMD = −0.58 [95% CI: −0.88, −0.28], I² = 78%). Analyses of publication bias and sensitivity showed an overall negative effect, although a small number of studies exerted greater influence. Subgroup analyses indicated a stronger effect of KMC in developing countries, compared to developed countries. Similarly, mothers with preterm as opposed to term delivery appeared to have greater reductions in depression scores upon KMC implementation.

Conclusion

The evidence suggests that KMC reduces depressive symptoms in birthing women, possibly with larger effects in resource-limited settings.

Impact

KMC may have potential benefits in repressing depressive phenotype in birthing women, particularly those delivering preterm infants.

This meta-analysis provides updated, quantitative evidence synthesizing diverse study designs and highlights differential effects across socioeconomic settings.

Inclusion of controlled trials with both pre- and post-test depression measures enhances the robustness of our findings compared with previous meta-analyses.

Our results indicate varied but stronger antidepressant effects of KMC, particularly in developing economies under resource-limited settings, compared to developed countries.

The evidence supports KMC as a low-cost, scalable, non-pharmacological intervention to improve maternal mental health and strengthen mother-infant outcomes across diverse settings.