Cattaneo A, Davanzo R, Worku B, Surjono A, Echeverria M, Bedri A, Haksari E, Osorno L, Gudetta B, Setyowireni D, Quintero S, Tamburlini G
Bureau for International Health, Istituto per l'Infanzia, Trieste, Italy.
Acta Paediatr. 1998 Sep;87(9):976-85. doi: 10.1080/080352598750031653.
A randomized controlled trial was carried out for 1 y in three tertiary and teaching hospitals, in Addis Ababa (Ethiopia), Yogyakarta (Indonesia) and Merida (Mexico), to study the effectiveness, feasibility, acceptability and cost of kangaroo mother care (KMC) when compared to conventional methods of care (CMC). About 29% of 649 low birthweight infants (LBWI; 1000-1999 g) died before eligibility. Of the survivors, 38% were excluded for various reasons, 149 were randomly assigned to KMC (almost exclusive skin-to-skin care after stabilization), and 136 to CMC (warm room or incubator care). There were three deaths in each group and no difference in the incidence of severe disease. Hypothermia was significantly less common in KMC infants in Merida (13.5 vs 31.5 episodes/100 infants/d) and overall (10.8 vs 14.6). Exclusive breastfeeding at discharge was more common in KMC infants in Merida (80% vs 16%) and overall (88% vs 70%). KMC infants had a higher mean daily weight gain (21.3 g vs 17.7 g) and were discharged earlier (13.4 vs 16.3 d after enrolment). KMC was considered feasible and presented advantages over CMC in terms of maintenance of equipment. Mothers expressed a clear preference for KMC and health workers found it safe and convenient. KMC was cheaper than CMC in terms of salaries (US$ 11,788 vs US$ 29,888) and other running costs (US$ 7501 vs US$ 9876). This study confirms that hospital KMC for stabilized LBWI 1000-1999 g is at least as effective and safe as CMC, and shows that it is feasible in different settings, acceptable to mothers of different cultures, and less expensive. Where exclusive breastfeeding is uncommon among LBWI, KMC may bring about an increase in its prevalence and duration, with consequent benefits for health and growth. For hospitals in low-income countries KMC may represent an appropriate use of scarce resources.
在亚的斯亚贝巴（埃塞俄比亚）、日惹（印度尼西亚）和梅里达（墨西哥）的三家三级教学医院开展了一项为期1年的随机对照试验，以研究与传统护理方法（CMC）相比，袋鼠式护理（KMC）的有效性、可行性、可接受性和成本。649名低出生体重婴儿（LBWI；1000 - 1999克）中约29%在符合条件前死亡。在幸存者中，38%因各种原因被排除，149名被随机分配到KMC组（稳定后几乎完全采用皮肤接触护理），136名被分配到CMC组（暖箱或暖房护理）。每组有3例死亡，严重疾病发生率无差异。在梅里达，KMC组婴儿体温过低情况显著较少（13.5次/100婴儿/天对比31.5次），总体上也是如此（10.8次对比14.6次）。在梅里达，KMC组婴儿出院时纯母乳喂养更为常见（80%对比16%），总体上也是如此（88%对比70%）。KMC组婴儿平均每日体重增加更高（21.3克对比17.7克），出院更早（入组后13.4天对比16.3天）。KMC被认为是可行的，且在设备维护方面比CMC更具优势。母亲们明确表示更喜欢KMC，医护人员也认为其安全方便。在薪资方面（11,788美元对比29,888美元）以及其他运营成本方面（7501美元对比9876美元），KMC比CMC更便宜。这项研究证实，针对体重1000 - 1999克的稳定低出生体重婴儿，医院采用KMC至少与CMC一样有效和安全，并且表明它在不同环境中可行，为不同文化背景的母亲所接受，且成本更低。在低出生体重婴儿中纯母乳喂养不常见的地方，KMC可能会提高其普及率和持续时间，从而对健康和生长带来益处。对于低收入国家的医院而言，KMC可能是对稀缺资源的一种合理利用。
