scholarly journals Comparison between Kangaroo Mother Care with Standard Care in Preterm Neonate Management

2019 ◽  
Vol 47 (3) ◽  
pp. 1-8
Author(s):  
Rumpa Mani Chowdhury ◽  
Mohammod Sahidullah ◽  
Md Abdul Mannan ◽  
MA Azad Chowdhury ◽  
Bidhan Chandra Biswas ◽  
...  

Preterm low birth weight (LBW) babies are unable to control their body temperature and are at greater risk of illness. Kangaroo Mother Care (KMC) is special ways of caring for low birth weight babies. KMC provide thermal care through continuous skin to skin contact, support for exclusive breast feeding and early recognition and response to complication. The aim of the study is to assess thermal control, morbidities feeding pattern of baby getting KMC in comparison to conventional care. The study also give estimation about duration and cost during hospital stay and growth between the babies of two groups. This Randomized Controlled Trial was conducted in the Department of Neonatology, BSMMU, Dhaka from December 2012 to October 2013. Fifty neonate with birth weight 1250 to 1800 gm, gestational age >30 weeks to <37 weeks, Hemodynamically stable after birth were selected. Twenty five of them were randomly allocated to KMC(Group-I) and 25 of them to Standard Method Care (Group-II). The mother or care giver provided KMC at least 12hours/day in Group-I. Those in Group-II were managed under radiant warmer. During hospital stay both the groups were monitored and after discharge, the neonates were followed weekly till 40 weeks of corrected gestational age. There were no differences in birth weight, gestational age, number of male/female neonates, places of delivery and mode of delivery between two groups. During hospital stay hypothermia (Group-I 4% vs Group-II 24%) and hyperthermia (Group I 8% vs Group II 32%) were significantly low in KMC group. Late onset neonatal sepsis (LONS) developed significantly in Group-II. Though incidence of culture negative LONS did not differ in two groups but incidence of blood culture positive LONS was significantly high in standard care neonates (36% vs.0%; p=0.001). Neonates with KMC care required significantly shorter time to reach full feeding and to start direct breast feeding; also incidence of feeding intolerance was significantly lower in this group. After initial loss, weight gain started earlier as well as achieved the birth weight earlier in KMC group. Morbidities like hyperglycaemia and apnoea were significantly higher in standard care group. Neonates who received standard care stayed significantly longer in the hospital and total cost during hospital stay was also significantly higher in this group. At 40 weeks corrected gestational age, KMC infants showed significantly higher daily weight gain than standard care group. This study concluded that Kangaroo Mother Care provides effective thermal control, decreases the incidence of sepsis, improves feed tolerance, helps to achieving full enteral feeding and birth weight earlier in preterm LBW neonates. KMC enhances growth during postnatal period. KMC also found to reduce hospital stay and treatment cost. Proper implementation of KMC for the management of preterm  low birth weight babies is safe and effective care. Bangladesh Med J. 2018 Jan; 47 (3): 1-8

2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Fay S. De Ocampo ◽  
Ma. Esterlita Villanueva-Uy

Objective. To determine the effectiveness of Kangaroo Mother Care (KMC) in increasing the rate of weight gain and decreasing hypothermia, apnea, and sepsis rate, and shorten hospital stay among low-birth-weight infants. Methods. Very low birth weight (VLBW) infants (≤1500 grams) were randomized to either the KMC or conventional care group. KMC provided skin-to-skin contact at least 6 hours per day while the conventional group received the usual care in the newborn intensive care unit (NICU). Daily weight measurements and weekly measurements of length, head, and chest circumference were recorded until discharge. Occurrence of hypothermia, apnea, sepsis, and length of stay was noted. Results. KMC group had a higher mean weight gain per day (p=0.0102). There was no difference in the length, head, and chest circumference between the two groups. Sepsis and apnea rates were not significant between the two groups. Significantly more neonates experience hypothermia in the control group (p<0.0069). Conclusion. KMC is effective in increasing the weight per day compared with the control group. KMC protects the neonates against hypothermia. There is not enough evidence to show a difference in the incidence of sepsis, apnea, and the length of hospital stay between the two groups.


2009 ◽  
Vol 1 (1) ◽  
pp. 24-28
Author(s):  
Sabera Khatun ◽  
Fawzia Hossain ◽  
Jannatul Ferdous ◽  
Afroza Chowdhury

ABSTRACT Objectives The incidence of low birth weight babies and the perinatal morbidity and mortality is inter-related. An understanding of the risk factors can help us to reduce their incidence and studying their management and outcome could help us to evolve optimal management strategies. The aim of the study was to find out the incidence of low birth weight and first week neonatal mortality rate. Methods The gestational age of the babies were determined and a comparison of the prenatal mortality ratio was done among vaginal and cesarean deliveries. During the study period all the patients irrespective of their gestational age admitted for delivery were recruited for the prospective analysis. Their gestational age, mode of delivery, birth weight and outcome were collected in a preformed data-sheet. Results During the study period there were 2689 deliveries at BSMMU and among them 301 were low birth weight (LBW), rest were normal birth weight babies. Forty-eight from low birth weight and seven from normal birth weight babies died within first-week of delivery. The LBW babies were grouped in to three groups according to their birth weight, 1-1.5 kg = group one, 1.6-2 kg = group two, 2.1- 2.4 kg = group three. It was found that 70% babies of group I, 40% of group II and 17% of group III were in the gestational age of 28-34 weeks. On the other hand 30% babies of group I, 60% of group II and 83% of group III were in the gestational age of 35-40 weeks. 79.36% of group I, 6.67% of group II and 0.63% of group III died within 7 days of birth. Conclusion Significant difference (p value < 0.001) was observed in first-week neonatal mortality among normal and low birth weight babies. Therefore, it can be concluded that birth weight and gestational age is an important determining factor for early neonatal death.


2021 ◽  
Vol 36 (2) ◽  
pp. 107-113
Author(s):  
Nishat Jahan ◽  
Md Mahbubul Hoque ◽  
MAK Azad Chowdhury

Background: Prematurity is the largest cause of neonatal mortality. They need incubators or radiant warmers which are expensive and very difficult to arrange in a resource constraint country. Kangaroo mother care (KMC) had been proposed as an alternative to conventional neonatal care for low birthweight (LBW) babies. Objectives: To observe the benefits of Kangaroo mother care in preterm low birth weight babies. Methods: This randomized controlled trial was conducted over 6 months in Dhaka Shishu Hospital. Neonates who were <1800 gm and hemodynamically stable were enrolled. Total 80 neonates were enrolled and divided into 2 groups: Kangaroo mother care group and conventional method care group (incubator/warmer). The mother or caregiver were taught for KMC, supervised by trained nurses round the clock. KMC was given at least 2 hours at a time and at least 12 hours in a day. When the baby was not in KMC at that time the baby was placed in cot with adequate coverings. During hospital stay both the groups were monitored. Results: In KMC group 25% and conventional care group 40% neonates became hypothermic. Among the study population 35% neonates in KMC and 65% neonates in conventional care groups developed sepsis (p= 0.007). More KMC babies were exclusively breastfed at the end of the study (95% vs 60%). The KMC babies had shown better growth: weight gain per day (18.35±7.81 grams vs 13.55±4.89 p<0.001) and length (0.99±0.70 vs 0.71±0.44 cm, p = 0.03). KMC babies were discharged earlier than conventional care baby. Conclusion: KMC provides significant improvement in exclusive breast feeding, reduction of infection, decrease hospital stay and gaining weight of the babies. It also helps in maintaining temperature better than conventional care. DS (Child) H J 2020; 36(2): 107-113


2006 ◽  
Vol 20 (4) ◽  
pp. 318-323 ◽  
Author(s):  
Renata Tolêdo Alves ◽  
Rosangela Almeida Ribeiro

It has been recently suggested that periodontal disease is an associated factor for prematurity and low birth weight. The aim of this work was to assess the periodontal status of puerperae and determine its possible relationship with preterm low birth weight (PLBW) delivery. The sample included 59 women seen at two maternity hospitals in Juiz de Fora, MG, Brazil. Nineteen mothers had premature and low birth weight babies (gestational age below 37 weeks and birth weight below 2,500 g - group I), and 40 had mature, normal weight babies (gestational age over 37 weeks and birth weight over 2,500 g - group II). The mothers' data were obtained from medical files, interview, and periodontal clinical examination carried out up to 48 hours after delivery. The Periodontal Screening and Recording (PSR) was used for periodontal assessment. The association between periodontal disease and PLBW was expressed as odds ratio (OR). There was a higher rate of periodontal disease in group I (84.21% - 16/19) as compared with group II (37.5% - 15/40). The data also showed a significant association between periodontal disease and PLBW (OR = 8.9 - 95% CI: 2.22-35.65 - p = 0.001). It was concluded that maternal periodontal disease was an associated factor for prematurity and low birth weight in this sample.


2018 ◽  
Vol 5 (2) ◽  
pp. 508 ◽  
Author(s):  
Prathiba N. Doddabasappa ◽  
N. S. Mahantshetti ◽  
Mahesh Kamate ◽  
Adarsh E.

Background: Low birth weight (LBW) is one of the risk factor for neurodevelopmental delay. The present study was undertaken to assess the role of the Kangaroo Mother Care (KMC) in the neurodevelopmental outcome of low birth weight babies. Methods: The present study was undertaken at Department of Paediatrics, Jawarharlal Medical college, Belgaum during the period from January 2009 to October 2010. The study includes 80 stable LBW babies were randomized into 40 in the KMC group and 40 in convention method of care group. 36 babies in the KMC group and 33 babies in the CMC group completed the study. The Neurodevelopmental outcome was assessed by the Amiel Tison test at three, six, nine and twelfth months of age. This was compared with BSID test, at one year.Results: The neurosensory examination and passive muscle tone (PMT) were found to be abnormal. Majority of the babies in both groups has a normal neurosensory and PMT development at one year. Statistically significant to muscle tone deficit was observed in the CMC babies at six months and nine months (p = 0.005 and p = 0.013). With respect to BSID, 16 and 29 KMC babies had a normal Psychomotor Development Index (PDI) and Motor Development Index (MDI) scores when compared to 8 and 18 CMC babies (p = 0.003 and p = 0.057 respectively). Number of babies with significant delay was observed to be higher in the CMC group being 11 versus 1 for PDI scores and 4 versus 1 for MDI scores.Conclusions: The present study shows that KMC has a beneficial effect on the neurodevelopmental outcome of low birth weight babies and BSID II is a better test to detect the psychomotor and mental developmental delay when compared to the Amiel Tison test.


2018 ◽  
Vol 61 (7) ◽  
pp. 1784-1793
Author(s):  
Lilian Cássia Bórnia Jacob-Corteletti ◽  
Eliene Silva Araújo ◽  
Josilene Luciene Duarte ◽  
Fernanda Zucki ◽  
Kátia de Freitas Alvarenga

Purpose The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). Method We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. Results In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. Conclusions Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.


2012 ◽  
Vol 6 (2) ◽  
pp. 24-26
Author(s):  
A Giri ◽  
AS Tuladhar ◽  
H Tuladhar

Aims: This study was conducted to evaluate maternal characteristics and obstetric outcomes among women with hyperemesis gravidarum during pregnancy. Methods: A prospective hospital based study was conducted at Nepal medical college and teaching hospital over the period of two years where all the women admitted with history of hyperemesis gravidarum were evaluated. Hyperemesis gravidarum was defined as intractable nausea/vomiting in pregnancy that leads to dehydration, nutritional deficiency, electrolyte and metabolic disturbances and considerable ketonuria that may require hospitalization. The age of women, parity, gestational age, method of treatment and duration of hospital stay were analysed.The fetal outcome evaluated were incidence of preterm birth, apgar score <7 at 5 mins of birth, low birth weight, perinatal deaths and congenital anomalies in baby. Results: There were 52 women admitted with hyperemesis gravidarum among all obstetric admission (N= 2080). The incidence of hyperemesis gravidarum was 2.5% of all pregnancy. The condition was seen more commonly in nulliparous (61.5%) than in multiparous women. It was less common in women of parity 3 or more. The problem was identified maximum (50%) in gestational age of 5-7 weeks though one case was seen in gestational age of 20 weeks also. The mainstay of treatment was supportive. The range of hospital stay was 1-10 days with mean hospital stay 2.26 days. The preterm delivery rate was 4.8% and none of the babies were low birth weight. All the babies had apgar score >7 at 5 mins of birth. There were no congenital anomalies and no perinatal deaths were noted. Conclusions: Women with hyperemesis gravidarum did not have adverse obstetric outcome in this study. NJOG 2011 Nov-Dec; 6 (2): 24-26 DOI: http://dx.doi.org/10.3126/njog.v6i2.6752


2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Priya Singh Rangey ◽  
Megha Sheth

Background. Massage therapy (MT) and kangaroo mother care (KMC) are both effective in increasing the weight and reducing length of hospital stay in low birth weight preterm infants but they have not been compared.Aim. Comparison of effectiveness of MT and KMC on body weight and length of hospital stay in low birth weight preterm (LBWPT) infants.Method. 30 LBWPT infants using convenience sampling from Neonatal Intensive Care Unit, V.S. hospital, were randomly divided into 2 equal groups. Group 1 received MT and Group 2 received KMC for 15 minutes, thrice daily for 5 days. Medically stable babies with gestational age < 37 weeks and birth weight < 2500 g were included. Those on ventilators and with congenital, orthopedic, or genetic abnormality were excluded. Outcome measures, body weight and length of hospital stay, were taken before intervention day 1 and after intervention day 5. Level of significance was 5%.Result. Data was analyzed using SPSS16. Both MT and KMC were found to be effective in improving body weight (P= 0.001,P= 0.001). Both were found to be equally effective for improving body weight (P= 0.328) and reducing length of hospital stay (P= 0.868).Conclusion. MT and KMC were found to be equally effective in improving body weight and reducing length of hospital stay.Limitation. Long term follow-up was not taken.


2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Jannie Lyne C. Notarte-Palisbo ◽  
Cindy D. Canceko-Llego

Objective. To compare outcomes of low-birth-weight neonates delivered before and after implementation of intermittent kangaroo mother care (KMC) in terms of duration of hospital stay, mortality rate, and clinical outcome. Methods. This is a retrospective analytical study that included all neonates delivered in a tertiary government hospital with birth weight of less than 2000 grams before and after intermittent KMC implementation from January 2015 to December 2016. Chart review was done for demographics, mortality profile, and length of hospital stay. Chi-square test and Student’s t-test were used to compare mortality rate and length of hospital stay, and odds ratio was used for mortality outcome. Results. A total of 677 low birth weight newborns were reviewed and of these, 276 (79.8%) neonates in group 1 (Pre-intermittent KMC implementation), and 263 (79.4%) neonates in group 2 (Post-intermittent KMC implementation) fulfilled the inclusion criteria. The duration of hospital stay of neonates enrolled in KMC was significantly shorter (p ≤ 0.05). In Groups 1 and 2, 93–94% of neonates were discharged improved with a 5–6% mortality of almost equal distribution. There was no significant difference in mortality between groups 1 and 2 (OR 1.19, 95% CI 0.59, 2.42). Conclusion. There was no significant difference in mortality rate and cause of death pre- and post-intermittent KMC implementation. However, the length of hospital stay among the LBW neonates discharged improved was significantly shortened.


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