The impact of partial kangaroo mother care on growth rates and duration of hospital stay of low birth weight infants In Kenyatta National Hospital
Abstract
lntrod uction:
Neonatologists Rey and Martinez in Bogota, Colombia introduced kangaroo
mother care in order to cope with the overcrowding, recurrent nosocomial
infections and scarcity of resources in hospitals caring for low birth weight infants
(4). This method of care consists of three components: Kangaroo position,
Kangaroo nutrition and Kangaroo discharge policies with strict follow-up (5).
Numerous studies both in developed and developing countries highlight the
practice of KMC in different settings, as well as its benefits and limitations. This
study assesses the impact of KMC on the duration of hospitalization and growth
rates of LBW infants subjected to it.
Objective: To determine the effect of KMC on the rates of growth and duration
of hospital stay ofLBW infants at the Newborn Unij of KNH.
Design: Randomized controlled trial.
Methods:
The study was carried out in Kenyatta National Hospital Newborn Unit over a
period of nine months. Growth rates and durations of hospital stay of the low birth
weight infants on Kangaroo mother care were compared with those of the infants
on the traditional method of care. A total of 156 infants were recruited with 81
infants in the control group and 85 infants in the KMC group. Each group was
stratified into two weight categories, the IOOO-1499g and 1500-1750g categories.
KMC was practised for eight hours per day.
Main outcome measures: Durations of hospital stay and growth rates of the
infants in the two groups were the outcome measures observed.
Results:
Baseline characteristics were similar in the two groups except for mothers' age.
The mean age of the mothers in the KMC group was 26.5 years while that of the
mothers in the control group was 24 years, P value of the difference being 0.04.
The mean weight at recruitment of the control group was 1489g while that of the
KMC group was 1480g. The mean gestation at recruitment of the KMC group
was 34 weeks while that of the control group was 34.8 weeks. The KMC group
infants demonstrated significantly higher growth rates as shown by the higher
mean weight gain of 22.Sg/kg/day compared with 16.7g/kg/day in the control
group, P value < 0.001; higher mean head circumference gain of 0.91 em/week
compared with 0.S4cmlweek in the control group, P value < 0.001 and higher
mean MUAC gain of 0.76cmlweek compared with 0.48cm/week in the control
group, P value 0.002. The KMC group stayed in the hospital for a mean duration
of 16.3 days compared with the 18.1 days in the control group, P value 0.199.
When the KMC and control groups in the two weight categories were compared
separately, the KMC infants demonstrated significantly higher mean weight, head
and mid upper arm circumference gains, P values < 0.05. The duration of hospital
stay was significantly shorter in the KMC infants in both weight categories, P
values <0.05. Using logistic regression analysis, KMC was the strongest predictor
of mean weight, mean head circumference and mean MUAC growth while
mother's older age was the strongest predictor of mean duration of stay, with
KMC being an independent predictor of duration of stay.
Conclusion:
The low birth weight infants offered KMC at KNH Newborn Unit demonstrated
higher growth rates and were discharged earlier. The results of this study suggest
that KMC should be promoted actively and mothers encouraged to start it as soon
as their LBW babies are stable.
Citation
Degree of Master of Medicine (paediatrics and child health)Publisher
University of Nairobi School of Medicine
Description
A dissertation submitted in part fulfillment
for the Degree of Master of Medicine (paediatrics and child health)
in the University of Nairobi