Anemia, nutrition and ambulatory oxygen weaning in a cohort of
oxygen-dependent premature infants.
Abstract
Background: In Bogotá, Colombia, oxygen-dependent (OD) preterm infants
are home discharged in Kangaroo Position, to a Kangaroo Mother Care
program (KMCP) with ambulatory oxygen, strict follow-up and oxygen
weaning protocols. Objectives: 1) to describe growth and morbimortality
up to 6 months of an OD preterm infants’ cohort. 2) to explore the
association between oxygen requirement, perinatal history, Hb levels,
transfusions, feeding patterns and growth. Methods: Prospective cohort
study. Descriptive and multivariate analysis. Results: 445 patients were
recruited with 33 weeks median gestational age (GA). 21% of mothers had
preeclampsia, 50% infections and 77% received antenatal
corticosteroids. Upon KMCP admission, median GA, chronological age and
hospital stay were 36 weeks, 19 and 17 days, respectively; 55.6% of
patients had neonatal sepsis and 66.6% were admitted to Neonatal
Intensive Care Unit. Patients had on average 52 days with oxygen, a
median of 3200g and 42 weeks GA at oxygen weaning. Median follow-up
oxygen saturation was 94% with 0.016-0.5 l/min of oxygen. One-year
mortality was 0.2% and attrition 20%. At 6 months, all patients had
appropriate growth and 66% were breastfeeding. Multiple regression
analysis showed that higher GA, Hb levels, weight gain, and exclusive
breastfeeding decreased oxygen requirement whilst invasive ventilation
and transfusions had the opposite effect (R2=0.48). Conclusions: In OD
preterm infants, there is a close relationship between days of oxygen
requirement and GA, mechanical ventilation, Hb levels at discharge,
transfusions, exclusive breastfeeding and weight gain. Strict monitoring
with established protocols in an ambulatory KMCP allows adequate growth
and safe oxygen weaning.