971 Clinical Course and Prognosis at One Year of 2800 Colombian Oxygendependent Infants Discharged Home with Oxygen in Kangaroo Position

Abstract

Objective: Evaluate clinical course and prognosis at one year of a cohort of oxygendependent (OD) preterm infants in our KMC program. Methods: Prospective cohort of 2800 OD preterm infants discharged in kangaroo position with periodical follow-up until 12 months corrected age to determine survival, growth, development and morbidity. Results: 6889 infants were admitted in ambulatory KMC program (2002-2009). 2800 were discharged with supplementary use of oxygen. 32% were < 30 weeks of GA, 56% were < 32 and 3% were born at term. 85,6% had completed follow up. Overall mortality was 1,6%, with 75% of deaths occurring between discharge and 3 months. 41,8% of infants were readmitted at least once. Main cause of readmission before 40 weeks GA was anemia (47,2%) and before 3 months was respiratory infection (91.4%). In average, oxygen was discontinued at 3431g. of weight. Breastfeeding was a success, with 41.2% receiving exclusive breastfeeding and 57.8% mixed feeding reaching term. Average weight, length and head circumference were 8557g, 71,4 and 45,4cm at one year of corrected age; Retinopathy was detected in 17,6% and blindness in 0,4%. Diagnosis of cerebral palsy at one year was 3%. Mean developmental coefficient at 12 months was 98,5. Conclusions: Our experience shows that weight is a major indicator of oxygen discontinuation. Weaning in our cohort reached its peak at 3431g. There is an unacceptable rate of OD in infants > 32 weeks GA that may be explained by inappropriate ventilation practices, suboptimal oxygen delivery and factors that need to be further explored.