Lamy Filho Fernando, Silva Antônio Augusto Moura da, Lamy Zeni Carvalho, Gomes Maria Auxiliadora Sousa Mendes, Moreira Maria Elizabeth Lopes
Departamento de Medicina III, Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil.
J Pediatr (Rio J). 2008 Sep-Oct;84(5):428-35. doi: 10.2223/JPED.1821.
To evaluate the results of the kangaroo mother method in Brazil.
A prospective cohort study comparing 16 units that have or do not have the second phase of the kangaroo mother method: eight were national centers of excellence for the kangaroo mother method (study group) and eight were part of the Brazilian Neonatal Research Network (control group). A total of 985 newborn infants with birth weights of 500 to 1,749 g were enrolled. Multivariate analyses employed multiple linear regression and Poisson regression with robust adjustment.
The adjusted analysis (controlled for birth weight, gestational age, Score for Neonatal Acute Physiology Perinatal Extension II, Neonatal Therapeutic Intervention Scoring System, and maternal age and educational level) demonstrated that mean length of hospital stay (p = 0.14) and intercurrent clinical conditions in the intermediate or kangaroo unit were equal for both groups. Weight (p = 0.012), length (p = 0.039) and head circumference (p = 0.006) at 36 weeks' corrected gestational age were all lower at the kangaroo units. The kangaroo units exhibited superior performance in relation to exclusive breastfeeding at discharge (69.2 vs. 23.8%, p = 0.022).
The evidence suggests that the humanization strategy adopted by the Brazilian Ministry of Health is a safe alternative to conventional treatment and a good strategy for promoting breastfeeding.
评估巴西袋鼠妈妈护理法的效果。
一项前瞻性队列研究,比较16个设有或未设有袋鼠妈妈护理法第二阶段的单位:8个是袋鼠妈妈护理法的国家级卓越中心(研究组),8个是巴西新生儿研究网络的一部分(对照组)。共纳入985名出生体重为500至1749克的新生儿。多变量分析采用多重线性回归和稳健调整的泊松回归。
调整分析(控制出生体重、胎龄、新生儿急性生理学围产期扩展II评分、新生儿治疗干预评分系统以及母亲年龄和教育水平)显示,两组在中间护理单元或袋鼠护理单元的平均住院时间(p = 0.14)和并发临床情况相同。矫正胎龄36周时,袋鼠护理单元的体重(p = 0.012)、身长(p = 0.039)和头围(p = 0.006)均较低。袋鼠护理单元在出院时纯母乳喂养方面表现更优(69.2%对23.8%,p = 0.022)。
证据表明,巴西卫生部采用的人性化策略是传统治疗的安全替代方案,也是促进母乳喂养的良好策略。