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Long-term outcome of preterm infants discharged home on kangaroo care in a developing country
R A Kambarami1, O Chidede, N Pereira
1Department of Paediatrics and Child Health, Faculty of Medicine, University of Zimbabwe, Harare, Zimbabwe. rosekamb@samara.co.zw
Insights
Kangaroo care benefits preterm infants. This study followed 297 infants for 12 months, finding maternal age under 20, low birthweight, and maternal complications were key risks for infant mortality.
Area of Science:
- Neonatal Medicine
- Pediatric Outcomes
- Public Health
Background:
- Kangaroo care (KC) is a method of care for preterm infants.
- Hospital-based studies suggest KC improves outcomes for preterm infants.
- Long-term effects of KC on preterm infants require further investigation.
Purpose of the Study:
- To assess the long-term outcomes of preterm infants discharged home on kangaroo care.
- To identify risk factors associated with mortality in preterm infants receiving KC.
Main Methods:
- A cohort of 297 preterm infants (500-1800g) discharged on KC from Harare Hospital were followed for 12 months.
- Data collected included birthweight, discharge weight and age, infant mortality, hospital re-admission rates, and maternal health outcomes.
- Statistical analysis compared outcomes between infants who died and those who survived.
Main Results:
- Mortality rate was 26.6% over 12 months, with 8.8% in-hospital mortality.
- Significant risk factors for infant mortality included maternal age <20 years, birthweight <1500g, and maternal mortality/chronic morbidity.
- Infant age and weight at discharge, and birthweight were not significantly associated with mortality.
Conclusions:
- Kangaroo care is associated with significant infant mortality in this cohort.
- Maternal factors and infant birthweight are critical determinants of survival.
- Targeted interventions for young mothers and low birthweight infants are crucial for improving outcomes.
Abstract:
Several hospital-based studies have shown the beneficial effect of kangaroo care on preterm infants. Long-term outcome was studied in 297 preterm infants born at Harare Hospital weighing 500-1800 g, discharged home on kangaroo care and followed up for 12 months. Of these, 79 (26.6%) died, 141 (47.5%) survived to complete follow-up and 77 (25.9%) were lost to follow-up. Of those who died, median birthweight was 1460 g, median age at hospital discharge 7 days, median weight at discharge 1400 g and median age at death 66 days. Of those who completed follow-up, median birthweight was 1575 g, median age at hospital discharge was 6 days and median weight at hospital discharge was 1500 g. Of those who were lost to follow-up, median age at loss to follow-up was 70 days, median birthweight was 1540 g, median age at hospital discharge was 5 days and median weight at hospital discharge was 1500 g. The hospital re-admission rate was 22.9% with 8.8% mortality. Maternal mortality and chronic morbidity rates were 4.7% and 7.4%, respectively. On comparing those who died with those who completed follow-up, mother's age <20 years, birthweight <1500 g and maternal mortality and chronic morbidity were significant risk factors for infant mortality. Age at discharge and weight at birth and on discharge were not significantly associated with infant mortality.
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