Charpak Y, Charpak N, Ruiz-Pelaez JG; International Society of Technology Assessment in Health Care. Meeting.

Abstr Int Soc Technol Assess Health Care Meet. 1993; 9: 133.

EVAL, Paris, France.

Traditional care for low Birth Weight babies includes prolonged neutral thermal environment (incubators), carefully controlled breast and artificial feeding and monitoring for common conditions such as apnea of prematurity, hypoglicemia, gastroesophageal reflux and infection, among others. Usually babies remain in hospital until an arbitrary weight (1700 to 2500 g) is reached and major medical problems are solved. This approach is expensive and exposes the infant to the usual risks of hospitalization, such as nosocomial infection. It also delays the beginning of a healthy relationship between the mother and the baby, and their integration within the family. In addition, in many less developed countries, there are not enough resources to care for all those infants at hospitals. As a result, neonatal units are overcrowded, and nosocomial infections and other conditions are frequently observed. In 1978, the Kangaroo Mother Programme was elaborated at one of the largest Obstetric Facilities (Instituto Materno Infantil -IMI-) in Santa Fe de Bogot/a, Colombia, as an alternative to the expensive and seldom available "traditional8 method. We conducted a non experimental study comparing the one year outcomes of two prospective cohorts of infants weighting less than 2000g, one with 162 infants who underwent the "Kangaroo8 intervention, and the other with 170 infants who underwent usual management, in two institutions. Kangaroo intervention consisted of a permanent skin to skin contact with the mother, exclusive breast feeding and early discharge from hospital. Kangaroo infants came from much lower socio-economic class, weighted less at birth and had more medical problems. The tendency toward a greater mortality of the kangaroo infants (RR = 1.9, NS) was inversed after adjustment on birth weight and gestational age (RR = 0.5, NS). Kangaroo infants grew less than control infants during the first trimester (they gained 500g less). Breast feeding was more frequent in Kangaroo infants (57% versus 33% at 6 months). Neurological development was more delayed in Kangaroo infants, but we could not isolate the Kangaroo intervention effect from that of lower socio-economic level and medical status at birth. We conclude that the Kangaroo intervention is effective as a substitute to incubators for infants having overcome major problems, but questions remain regarding exclusive breast feeding and early discharge from hospital.

Publication Types:

• Meeting Abstracts

Keywords:

• Birth Weight
• Body Weight
• Breast Feeding
• Cohort Studies
• Colombia
• Developed Countries
• Empathy
• Humans
• Infant
• Infant Care
• Infant Mortality
• Infant Nutrition Physiology
• Infant, Low Birth Weight
• Infant, Newborn
• Infant, Premature
• Longitudinal Studies
• Mothers
• Weights and Measures
• hsrmtgs

Other ID:

• HTX/94906408

UI: 102211517

From Meeting Abstracts