Joseph Jessy, Jalal Ruchita, Nagrath Monal, Dasgupta Rajib, Chellani Harish, Pandey R M, Sood Mangla, Goyal Rajat, Ramji Siddarth
International Aids Vaccine Initiative (IAVI), India.
Department of Community Health, Jawaharlal Nehru University, New Delhi.
Indian Pediatr. 2022 Oct 15;59(10):763-768. Epub 2022 Jul 12.
To determine the burden of early growth faltering and understand the care practices for small and sick babies discharged from newborn units in the district.
Observational and follow-up study.
512 babies discharged from two Special Newborn Care Units (SNCUs) and four Newborn Stabilization Units (NBSUs) in two districts of Himachal Pradesh.
Anthropometric assessments, interview of mothers and Accredited Social Health Activists (ASHAs) conducted between August, 2018 and March, 2019. Change in weight-for-age z-score (DWAZ) of <-0.67SD between birth and assessment was used to define growth faltering.
Proportion of growth faltering (or catch-down growth) in small and sick babies discharged from SNCUs and NBSUs, and infant care practices.
Growth faltering was observed in a significant proportion of both term (30%) and preterm (52.6%) babies between 1 to 4 months of age. Among babies with growth faltering (n=180), 73.9% received a home visit by ASHA, and only 36.7% received a follow-up visit at a facility. There were 71.3% mothers counselled at discharge (mostly informed about breast feeding). Most (96.7%) mothers did not perceive inadequate weight gain in their babies post-discharge. During home visits, ASHAs weighed 61.6% of the infants with growth faltering. Amongst infants who had growth faltering, only 49.6% of mothers had been provided information about their infant's growth and 57.1% mothers had received breastfeeding counselling.
Small and sick newborn infants (both term and preterm babies) discharged from special care newborn units are at increased risk of early growth faltering. Follow-up care provided to these infants is inadequate. There is a need to strengthen both facility-based and home-based follow up of small and sick newborn infants discharged from newborn care facilities.
确定早期生长发育迟缓的负担，并了解该地区新生儿病房出院的体弱多病婴儿的护理情况。
观察性随访研究。
来自喜马偕尔邦两个地区的两个特殊新生儿护理单元（SNCU）和四个新生儿稳定单元（NBSU）的512名出院婴儿。
在2018年8月至2019年3月期间进行人体测量评估，并对母亲和经认证的社会健康活动家（ASHA）进行访谈。出生与评估之间年龄别体重z评分（DWAZ）变化<-0.67SD用于定义生长发育迟缓。
SNCU和NBSU出院的体弱多病婴儿（包括足月儿和早产儿）中，1至4个月大的婴儿出现生长发育迟缓（或追赶生长）的比例较高。在生长发育迟缓的婴儿（n = 180）中，73.9%接受了ASHA的家访，只有36.7%在医疗机构接受了随访。71.3%的母亲在出院时接受了咨询（主要是关于母乳喂养的信息）。大多数（96.7%）母亲在出院后没有察觉到自己孩子体重增加不足。在家访期间，ASHA对61.6%生长发育迟缓的婴儿进行了称重。在生长发育迟缓的婴儿中，只有49.6%的母亲得到了关于其婴儿生长情况的信息，57.1%的母亲接受了母乳喂养咨询。
从特殊护理新生儿病房出院的体弱多病新生儿（包括足月儿和早产儿）早期生长发育迟缓的风险增加。对这些婴儿提供的后续护理不足。有必要加强对新生儿护理机构出院的体弱多病新生儿的机构随访和家庭随访。
