S Chandra, M Gupta, T Nain, A Mishra, K Agarwal

Abstract

Introduction: Hypoxic ischaemic encephalopathy (HIE) is a significant cause of mortality and short and long term morbidities. Aim: To study the effect of Kangaroo Mother Care (KMC) on outcomes in babies with mild and moderate HIE. Methods: In this un-blinded randomised controlled trial over a duration of 30 months, all inborn neonates with mild and moderate HIE (defined by Levene's staging), irrespective of gestational age, were included in the study. Neonates were partitioned into an intervention or KMC group (those receiving KMC in addition to the ongoing management) and a control group (receiving only medical and supportive management). The two groups were later analysed for primary (good or poor) and secondary outcomes (including mean duration of Neonatal Intensive Care Unit (NICU) stay, mean duration of hospital stay and progression of stage of HIE). Data were analysed using the Epi-info software version 7.2.0.1. Results: Out of 165 patients with HIE, 35 patients were excluded (due to different reasons) and the remaining were divided into a KMC or intervention (n=65) and control groups (n=65). Primary outcome was good in 56 (86.1%) patients and poor in 9 (13.8%) patients in the KMC group. Mean duration of NICU stay was 3.14 days (1.00-20.00; SD 3.88) in the KMC group which was significantly less than (p=0.005) 5.19 days (1.00-23.00; SD 4.244) in the control group. Mean duration of hospitalisation was not statistically different in the case and control groups (p=0.208). Progression from mild to moderate HIE was seen in 2 (2/65=3.0%) patients in the KMC group and showed marginal statistical significance (p=0.081) compared with the control group where progression was seen in 9 (9/65=13.8%). Conclusion: Patients with mild to moderate HIE in NICU receiving KMC had a significantly shorter duration of NICU stay thus prompting more robust research on this subject.