Gavhane Sunil, Eklare Deepak, Mohammad Haseeb
Assistant Professor, Department of Paediatrics, MGM Medical College , Aurangabad, Maharashtra, India .
Neonatologist, Department of Paediatrics, Niramay Hospital , Nanded, Maharashtra, India .
J Clin Diagn Res. 2016 Dec;10(12):SC13-SC15. doi: 10.7860/JCDR/2016/23855.9006. Epub 2016 Dec 1.
Kangaroo Mother Care (KMC) has been gaining acceptance as an effective alternative to incubator based Conventional Medical Care (CMC) in preterm or Low Birth Weight (LBW) infants especially in resource scarce developing countries.
To report and analyse the long-term effects of KMC for relatively stable Very Low Birth Weight (VLBW) infants on nutritional indicators and feeding conditions at 6-12 months of corrected age.
This randomized controlled trial was done at a Level III Neonatal Intensive Care Unit (NICU) of a teaching institution in southern India. One hundred and forty neonates with birth weight <1500gm were enrolled. Inborn singleton, VLBW (birth weight <1500gm) infants, tolerating spoon feeds of 150mL/kg/day and haemodynamically stable (not on oxygen or respiratory support, no apnea for 72 hours, not on any intravenous fluids) were eligible. Infants with major malformation were excluded. Babies were randomized to KMC group or CMC group. At 6 to 12 months corrected age, the assessment included the measurement of growth parameters in terms of malnutrition, wasting, stunting and having small head. Feeding information was collected in relation to duration of exclusive or partial breastfeeding (months of chronological age and of corrected age), the age (chronological age and corrected age) at which weaning diet was started and the type of weaning diet. Comparisons between study groups for primary outcomes and secondary outcomes were performed with Odds Ratio (OR) calculator using Medcalc online statistical software.
A total of 91 infants were followed at 6-12 months of corrected age. There was no difference between two groups in the incidence of malnutrition, wasting, stunting and having small head (47.7% vs 31.9%, p-0.13), (34.1% vs. 31.9%, p-0.83), (22.7% vs 12.8%, p-0.22) and (18.2% vs.31.9%, p-0.14). Although KMC group babies had better head growth and lesser weight and length compared to the CMC group, it was not statistically significant. The breast feeding and weaning rates at 6 months post birth were similar in both the groups.
KMC group does not differ significantly with CMC group in terms of long-term growth and feeding pattern at 6 to 12 months of corrected age.
袋鼠式护理（KMC）作为基于暖箱的传统医疗护理（CMC）的一种有效替代方法，在早产儿或低出生体重（LBW）婴儿中越来越被认可，尤其是在资源匮乏的发展中国家。
报告并分析袋鼠式护理对相对稳定的极低出生体重（VLBW）婴儿在矫正年龄6至12个月时营养指标和喂养状况的长期影响。
这项随机对照试验在印度南部一家教学机构的三级新生儿重症监护病房（NICU）进行。招募了140名出生体重<1500克的新生儿。符合条件的是单胎、出生体重<1500克的VLBWWLBW婴儿，能耐受每天150毫升/千克的小勺喂养且血流动力学稳定（未接受氧气或呼吸支持，72小时内无呼吸暂停，未接受任何静脉输液）。患有严重畸形的婴儿被排除。婴儿被随机分为袋鼠式护理组或传统医疗护理组。在矫正年龄6至12个月时，评估包括测量营养不良、消瘦、发育迟缓及小头畸形方面的生长参数。收集与纯母乳喂养或部分母乳喂养持续时间（实际年龄和矫正年龄的月数）、开始断奶饮食的年龄（实际年龄和矫正年龄）以及断奶饮食类型相关的喂养信息。使用Medcalc在线统计软件通过比值比（OR）计算器对研究组之间的主要结局和次要结局进行比较。
共有91名婴儿在矫正年龄6至12个月时接受随访。两组在营养不良、消瘦、发育迟缓及小头畸形的发生率方面无差异（47.7%对31.9%，p = 0.13），（34.1%对31.9%，p = 0.83），（22.7%对12.8%，p = 0.22）以及（18.2%对31.9%，p = 0.14）。尽管与传统医疗护理组相比，袋鼠式护理组婴儿的头部生长较好，体重和身长较小，但差异无统计学意义。两组在出生后6个月时的母乳喂养率和断奶率相似。
在矫正年龄6至12个月时，袋鼠式护理组与传统医疗护理组在长期生长和喂养模式方面无显著差异。
