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Table 8 Multivariable regression analyses of survival and major clinical outcomes

From: Transforming neonatal nursing: a randomized controlled trial comparing kangaroo care and standard protocols for survival in preterm infants with respiratory distress syndrome

Outcome/model

Predictor variable

Adjusted estimate

95% CI

p-value

Model performance

Survival analysis (Cox proportional hazards model)1

KMC implementation

0.42 (HR)

0.28–0.63

<0.001

 

Gestational age (per week)

0.76 (HR)

0.68–0.85

<0.001

 

Birth weight (per 100 g)

0.82 (HR)

0.75–0.90

<0.001

 

Initial SAS score

1.28 (HR)

1.14–1.44

<0.001

 

Maternal age

0.98 (HR)

0.94–1.02

0.324

28-Day survival (logistic regression model)²

KMC (vs. standard care)

2.84 (OR)

1.96–4.12

<0.001

AUC = 0.86 (95% CI 0.82–0.90)³

 

Gestational age ≥ 32 weeks

2.16 (OR)

1.58–2.95

<0.001

 

Birth weight ≥ 1500 g

1.92 (OR)

1.44–2.56

<0.001

 

Initial SAS score < 5

1.68 (OR)

1.26–2.24

<0.001

 

Exclusive breastfeeding

1.54 (OR)

1.18–2.01

0.002

Nosocomial infection-free survival (logistic regression model)

KMC > 6 h/day

2.46 (OR)

1.82–3.32

<0.001

AUC = 0.82 (95% CI 0.78–0.86)

 

Birth weight (per 100 g)

1.28 (OR)

1.16–1.41

<0.001

 

CPAP duration < 4 days

1.76 (OR)

1.32–2.34

<0.001

 

Early feeding initiation

1.62 (OR)

1.24–2.12

<0.001

Early discharge success⁴ (logistic regression model)

KMC adherence > 80%

2.32 (OR)

1.74–3.09

<0.001

AUC = 0.84 (95% CI 0.80–0.88)

 

Weight gain > 15 g/kg/day

1.94 (OR)

1.46–2.58

<0.001

 

Exclusive breastfeeding

1.86 (OR)

1.42–2.44

<0.001

 

No infections

1.72 (OR)

1.28–2.31

<0.001

Length of stay (linear regression)5

KMC implementation

−5.84 (β)

−7.12, − 4.56

<0.001

R² = 0.64; Adjusted R² = 0.62

 

Gestational age

−2.16 (β)

−2.84, − 1.48

<0.001

 

Birth weight

−0.94 (β)

−1.28, − 0.60

<0.001

 

Nosocomial infection

4.86 (β)

3.42, 6.30

<0.001

  1. KMC Kangaroo mother care; CI confidence interval; SAS Silverman Anderson score; CPAP continuous positive airway pressure; AUC area under the curve; VIF variance inflation factor
  2. 1Cox model stratified by study site with robust standard errors
  3. 2All logistic models adjusted for study site and maternal characteristics
  4. 3AUC area under the receiver operating characteristic curve
  5. 4Early discharge is defined as discharge before day 21 of life
  6. 5Linear regression with robust standard errors, controlling for clustering by site
  7. Model Diagnostics:
  8. All models checked for multicollinearity (VIF < 3 for all variables)
  9. Proportional hazards assumption tested and met for the Cox model
  10. Hosmer-Lemeshow goodness-of-fit tests non-significant for all logistic models
  11. Residual plots examined for linear regression with no significant violations
  12. Abbreviations: KMC = Kangaroo Mother Care; CI = Confidence Interval; SAS = Silverman Anderson Score; CPAP = Continuous Positive Airway Pressure; AUC = Area Under the Curve; VIF = Variance Inflation Factor