title: Evaluation of retinopathy of prematurity screening in reverse Kangaroo Mother Care: a pilot study.
abstract: OBJECTIVE
  To evaluate retinopathy of prematurity (ROP) screening practice in reverse Kangaroo Mother Care (R-KMC) with respect to stress and pain to the infant.
  
  
  METHODS
  In a pilot study we evaluated ROP screening practice in R-KMC in 20 babies at risk of ROP. The R-KMC differed from the conventional KMC with respect to the baby position where the baby lay supine on mother's chest. With the mother lying supine and the baby in R-KMC position, screening examinations were done with indirect ophthalmoscope. The outcome measures included stress (quantified by pulse, respiration, and oxygen saturation) and pain to the baby by observing facial expression (eye squeezing, crying, and brow bulge). The heart rate, respiratory rate, and SpO2 (%) were compared before and immediately after the procedure using paired t-test.
  
  
  RESULTS
  Mean (±SD) gestational age and birth weight were 30.8±2.3 weeks and 1362.5±253.9 g, respectively. During examination in R- KMC position 8 babies (40%) were completely relaxed (no eye squeezing and crying), 10 (50%) were partially relaxed (no brow bulge) and 2 babies (10%) were not relaxed. A change in heart and respiration rate both by 10 per minute was recorded in 12 (60%) and 10 (50%) babies, respectively. Five babies (25%) had reduction in blood oxygen concentration below 92%. The majority of the mothers (19 of 20) were relaxed.
  
  
  CONCLUSIONS
  ROP screening in R-KMC can be a baby friendly screening practice with respect to stress and pain to the infant and needs further evaluation in a larger cohort.
authors.affiliation: Retina-Vitreous Service, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: T R
authors.initials: TR
authors.lastname: Padhi
authors.affiliation: Retina-Vitreous Service, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: D
authors.initials: D
authors.lastname: Sareen
authors.affiliation: Infosys Pediatric Center, Capital Hospital, Bhubaneswar, India.
authors.forename: L
authors.initials: L
authors.lastname: Pradhan
authors.affiliation: Srimati Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: S
authors.initials: S
authors.lastname: Jalali
authors.affiliation: Retina-Vitreous Service, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: S
authors.initials: S
authors.lastname: Sutar
authors.affiliation: Srimati Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: T
authors.initials: T
authors.lastname: Das
authors.affiliation: Retina-Vitreous Service, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: R R
authors.initials: RR
authors.lastname: Modi
authors.affiliation: Retina-Vitreous Service, LV Prasad Eye Institute, Bhubaneswar, India.
authors.forename: U C
authors.initials: UC
authors.lastname: Behera
mesh_terms: D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D060127:Kangaroo-Mother Care Method; D015997:Neonatal Screening / Q000379:methods*; D010146:Pain / Q000517:prevention & control; D056888:Patient Positioning; D010865:Pilot Projects; D056152:Respiratory Rate / Q000502:physiology; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D013315:Stress, Psychological / Q000503:physiopathology / Q000517:prevention & control*