A mother-newborn care bundle tracked a 0.63 µg/dL cortisol-change gap—but allocation was not random

In 180 preterm infants, cortisol fell 0.20 µg/dL in a mother-newborn unit and rose 0.43 in conventional NICU care. Bed availability set the groups, while KMC exposure, feeding and heel-stick position also changed. This is a bundle signal, not an isolated zero-separation effect.

THE HOT TAKE

This is a signal from a whole care bundle, not a clean estimate of what separation alone does.

A prospective cohort at one tertiary hospital in North India assessed 200 preterm infants from August 2020 through March 2021. Fourteen infants above 1,800 g and six with major congenital anomalies were excluded. The analysis included 90 infants in a 12-bed mother-newborn care unit (MNCU) and 90 in conventional NICU care. MNCU admission depended on bed availability; when the unit was full, eligible infants went to the NICU.

All 180 infants had cortisol measured within 24 hours of birth and again at discharge or day 7, whichever came first. Baseline means were similar: 1.70 µg/dL in the NICU and 1.73 µg/dL in the MNCU (difference +0.03, 95% CI −0.10 to +0.16; P=.57). At the second sample, means were 2.14 and 1.53 µg/dL, respectively (difference −0.61, 95% CI −0.87 to −0.35; P<.001). Mean change was +0.43 versus −0.20 µg/dL; the paper reports a between-group change of −0.63 µg/dL (95% CI −0.68 to −0.51; P<.001).