972 Clinical Course, Prognosis and Health Care Insurance of a Cohort of Low Birth Weight Infants Discharged in Kangaroo Position

Abstract

Objective: Clinical course and prognosis at one year of a LBWI cohort cared in a ambulatory kangaroo mother care program (KMCP) according to health care insurances: Private prepaid plan (high income- HI) Contributive plan (middle and low-MLI) and subsidized plan (very low-VLI).Methods: Prospective LBWI cohort discharged in a KMCP with follow-up until 12 months to determine survival, growth, development and morbidity. Same guidelines were implemented in all types of health care insurance.Results: On 6889 infants admitted: 4% were from HI, 90% from MLI and 6% from VLI plans. Overall mortality was 1.6% for the three groups. While 100% of deaths for HI infants occur during hospitalization, 24% and 45.5% in MLI and VLI groups were at home. Frequency of infectious diseases was markedly increased in VLI (25.8% in HI vs. 50% in VLI). Nearly half of patients in MLI and VLI received exclusive breastfeeding up to term versus 4.6% in HI. Weight, length and head circumference at birth and at one year of corrected age didn't show great variation between groups. Cerebral palsy at one year was increased in VLI group: 3.5% vs.1.8% in HI and 1.3% in MLI. Mean developmental coefficient at 12 months didn't show variation between groups.Conclusion: Results of KMC implementation are similar independently of the type of health care insurance. Mortality and anthropometric indices during follow up were the same, but morbidity was increased in VLI group. KMC rules rigorously applied provide same benefits to all LBWI in Colombia regardless of socio economic level.