The Impact of Kangaroo Mother Care on the Outcome of Premature Babies at the Regional Hospital Buea

Yolande Djike Puepi F
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Abstract

Background: Prematurity and its complications are the leading causes of neonatal death. Kangaroo Mother Care (KMC) is one of the neonatal interventions to prevent these main complications, improve the outcome of preterm babies and reduce neonatal mortality due to prematurity. This study was conducted to assess the impact of KMC on the morbidity and mortality of premature babies in a semi-urban setting in Cameroon. Method: This study was a hospital-based retrospective cohort study carried out at the Buea Regional Hospital from February to April 2021. The files of neonate patients born before 37 weeks of completed pregnancy and who were hemodynamically stable were extracted and used. Participating babies selected were sorted into two groups: those who were cared for conventionally and those who were cared for through KMC. Some variables were obtained and compared between the 2 cohorts including: prevalence of hospitalisation, complications, duration of hospitalisation, mortality rate, rate of post discharge follow-up, rate of breastfeeding and increase in anthropometric parameters (head circumference, length and weight). Results: One hundred and twenty four premature babies were retained. Forty four of these were cared for conventionally and 80 cared for through KMC. Admissions significantly increased with KMC p<0.001). The main complications before and after KMC institution were and remained: infection, jaundice, respiratory distress and anaemia. There was a reduction in the frequency of some morbidities with KMC (infection, Necrotic Enterocolitis, hypoglycaemia and feeding difficulties), though the decrease was not statistically significant (p= 0.227, 0.285, 0.353 and 0.123 respectively). The frequency of respiratory distress, apnoea and hypothermia increased with KMC, but the changes were not significant (p= 0.551, 1.000 and 0.131 respectively). There was no significant change in duration of hospitalization between the cohorts (p= 0.637). Mortality rate reduced with KMC, though not significantly (p= 0.786). KMC significantly promoted the practice of exclusive breastfeeding both in hospital and at home (p<0.001). Post-discharge follow-up significantly improved after KMC was instituted (p<0.001). Head circumference and length increased, while weight reduced at discharge with KMC, but the changes were not statistically significant (p= 0.348, 0.118 and 0.438 respectively). Conclusion: KMC significantly increased admissions in this study. Mortality rate, infection and some other morbidities reduced, anthropometric parameters were better at discharge and post-discharge follow up improved for babies cared for through KMC. Implementation of KMC therefore has a positive effect on the outcome of preterm babies and should be intensified in resource-poor settings. Keywords: Kangaroo Mother Care; Neonates; Growth; Outcome; Cameroon
袋鼠妈妈护理对地区医院早产儿结局的影响
背景:早产及其并发症是新生儿死亡的主要原因。袋鼠妈妈护理(KMC)是新生儿干预措施之一,以防止这些主要并发症,改善早产儿的结局和减少新生儿死亡率,由于早产。本研究旨在评估喀麦隆半城市环境中KMC对早产儿发病率和死亡率的影响。方法:本研究是一项以医院为基础的回顾性队列研究,于2021年2月至4月在Buea地区医院进行。选取妊娠37周前出生且血流动力学稳定的新生儿资料进行分析。被选中的参与实验的婴儿被分成两组:一组是由传统方式照顾的,另一组是由KMC照顾的。获得并比较两个队列之间的一些变量,包括:住院率、并发症、住院时间、死亡率、出院后随访率、母乳喂养率和人体测量参数(头围、长度和体重)的增加。结果:早产儿124例。其中44人由传统方式照顾,80人由KMC照顾。KMC患者入院人数显著增加(p<0.001)。KMC住院前后的主要并发症为感染、黄疸、呼吸窘迫和贫血。KMC的一些发病率(感染、坏死性小肠结肠炎、低血糖和喂养困难)的频率有所下降,但下降的频率无统计学意义(p分别为0.227、0.285、0.353和0.123)。呼吸窘迫、呼吸暂停和体温过低的发生频率随KMC的增加而增加,但变化不显著(p分别为0.551、1.000和0.131)。两组患者住院时间差异无统计学意义(p= 0.637)。KMC降低了死亡率,但没有显著性差异(p= 0.786)。KMC显著促进了医院和家庭纯母乳喂养(p<0.001)。术后随访明显改善(p<0.001)。头围和体长增加,体重减少,但变化无统计学意义(p分别为0.348、0.118和0.438)。结论:KMC显著增加了本研究的入院率。通过KMC护理的婴儿死亡率、感染率和其他一些发病率降低,出院时人体测量参数更好,出院后随访改善。因此,KMC的实施对早产儿的预后有积极影响,应在资源贫乏的环境中加强。关键词:袋鼠妈妈护理;新生儿;经济增长;结果;喀麦隆
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