One hundred and fifty six babies with birth weight between 1500-2000 g and 103 full term-appropriate for gestational age (FT-AGA) babies delivered at University Hospital, District Hospital and village homes were included for a comparative study of mortality, morbidity and growth pattern. The low birth weight (LBW) babies from the three centres had similar birth weight and gestational age. Neonatal mortality rates for the LBW babies were similar at the three centres. The main cause of death were infections and aspiration with rates again being similar. Diarrhea and respiratory tract infections were common causes of morbidity. The mortality rates for the LBW babies were significantly higher as compared to FT-AGA babies irrespective of the place of delivery. The incidence of morbidities like diarrhea and respiratory infections were also higher in LBW babies. However, the differences were statistically significant mostly in the preterm group. The weight gain of all LBW babies was similar up to 3 months of age. The findings of an identical outcome for the LBW babies at village level to those managed at hospitals is an encouraging trend to increasing domiciliary care for LBW babies.
PIP: Between February 1985 and January 1986 in India, pediatricians compared outcomes of 156 low birth weight (LBW) infants (1500-2000 g) with those of 103 full term-appropriate for gestational age (FT-AGA) infants. They followed up on the infants at 15 days, 1 month, 2 months, and 3 months. The LBW infants consisted of 55 full term-intrauterine growth retardation (FT-IUGR) infants and 101 premature infants. Both sets of infants were born at Banaras Hindu University Hospital and Ishwari Memorial District Hospital both in Varanasi and in 10 villages of Cholapur Block in Varanasi. The village mothers were trained in neonatal care, which included general cleanliness, hand washing, adequate baby clothing, maintenance of body temperature, and cord care with spirits and triple dye. The birth weight and gestational age of LBW infants from the 3 centers were similar. The neonatal mortality rate was essentially the same for LBW infants in all 3 groups (e.g., 21% for the university hospital, 18% for the district hospital, and 18% for the villages). The neonatal mortality rate for LBW infants was significantly higher than that of FT-AGA infants (p .01 for university hospital, p .05 for district hospital, and p .05 for villages). The death rate due to infection was similar for all 3 groups (58%, 55%, and 66%, respectively). Diarrhea and upper respiratory infection were common causes of morbidity. Diarrhea and upper respiratory infection occurred more often in FT-IUGR infants and premature infants than in FT-AGA infants. The differences tended to be significant only between premature infants and FT-AGA infants, however.. The LBW infants born in the villages gained weight at a similar rate as those born in the university and district hospitals. These findings suggest that adequate care includes health and nutrition education, follow-up, and parental participation of infant's health care.