272 - Results from the follow up of preterm or Low Birth Weight infants with ambulatory oxygen in two Kangaroo Mother Care Programs of Bogotá, Colombia during the last 23 years.

From 1998 to 2021, 15-43% of patients in the Kangaroo Mother Care (KMC) program of Bogotá, Colombia (2600m above sea level), are oxygen dependent at entry and between 7 and 43% had bronchopulmonary dysplasia (BPD) defined as oxygen dependency more than 28 days and at 40 weeks GA.
The KMC Method encourages early home discharge of preterm/low-birthweight (LBW) infants that regulate their temperature in the Kangaroo Position (KP). Once discharge criteria are met, parents are empowered in the care of their baby. In the ambulatory KMC program, strict monitoring of oxygen-dependent (OD) patients is carried out, initially daily with dynamic oximetry, and later weekly, until the baby reaches 40 weeks GA. After the term, during the high-risk follow-up, the infant will come back every 2 weeks until oxygen weaning and will be followed until 12 months of corrected age.

Objective: to determine BPD incidence in two KMC programs from Bogotá, Colombia, and to evaluate health and nutritional status at 12 months.

Design/Methods: Historical cohort; 11,953 OD infants were included between January 1998 and the first semester of 2021. BPD incidence per year, feeding patterns, growth, hospital readmission up to 12 months, development coefficient (DC), the incidence of retinopathy of prematurity (ROP), abnormal audiometry, and mortality are described.

Results: A decrease in the cumulative incidence of BPD at 40 weeks from 20% in 2008-2012 to 5.5% in 2020-2021 was found. There were no major differences with the overall population regarding anthropometric measures; on the other hand, there was a difference of 1.6 points in the mean value of DC at 12 months. In the group of very low birth weight infants ( < 1500g) there were no differences in anthropometric measures and neither in the mean value of DC at 6 or 12 months. Comparing infants with and without BPD, those with BPD had 5.3 times more ROP and underwent surgery for ROP 9.7 times more. In addition, infants with BPD had abnormal audiometry 2 times more compared with infants without BPD. Mortality at 40 weeks was quite similar, but at 12 months was 3 times higher among infants with BPD. Furthermore, rehospitalization at 12 months was 1.7 times more. Patients followed without BPD received more breast milk at 12 months.

Conclusion(s): outpatient follow-up of OD preterm or LBW infants in KMC programs allows for adequate growth with breast milk-based nutrition and close monitoring of sensory and neurodevelopmental morbidities, frequent in this population.