Outcomes and Disease Spectrum of LBW Neonates in a Secondary Health Facility (original) (raw)
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Annals of Medical and Health Sciences Research, 2018
Background: Low birth-weight in infants is further categorized as Extreme low-birth weight (ELBW), Very low-birth weight (VLBW) and Low-birth weight (LBW) when weight at birth is <1 kg, ≥ 1 kg to <1.5 kg and ≥ 1.5 kg to <2.5 kg respectively. It is not clear how these various categories predict co-morbidities, duration of hospital stay and survival in affected newborns. Identifying such relationships will help prioritization of care, and this study is designed to explore these. Methods: This is a prospective study conducted over a 45 months period at the neonatal intensive care unit (NICU) of the Enugu State University Teaching Hospital (ESUTH), Enugu, Nigeria. Results: A total of 167 LBW newborns were enrolled, with about 90% born preterm. ELBWs constituted 20 (12.0%), while 47 (28.1%) and 100 (59.9%) were VLBW and LBW respectively. About 50 (32%) of the babies did not survive. Of these number, 16/20 (80%) were ELBW babies, 19/47 (41%) were VLBW while 15/91 (17%) were LBW b...
Annals of Tropical Paediatrics, 2008
Introduction: Low birth weight has a significant impact on the survival of a newborn. Low birth weight babies are at risk for a number of serious clinical problems and as such contribute to overall neonatal mortality and morbidity. Aims: The aim was to study the clinicoepidemiological profile and predictors of mortality in low birth weight babies in resource limited settings. Materials and methods: This was a prospective observational study conducted from July 2013 to May 2015. The study group included neonates admitted in NICU having birth weight less than 2500 gms. Newborns with congenital or chromosomal anomalies were excluded from the study. Data was collected regarding various epidemiological and clinical parameters and entered as per a preset proforma. Results and inference: Total of 100 eligible LBW newborns were studied. Incidence of LBW admission was found to be 17.3%. There were 26 deaths among LBW neonates. Birth weight, gestational age, mechanical ventilation, shock on admission, NEC, sepsis, and CRIB score were found to have a statistically significant association with mortality.
Pediatric Health, Medicine and Therapeutics
Background: Low birth weight neonates are subjected to different comorbidities due to anatomical and physiological immaturity. Globally, 60-80% of neonatal mortality was due to low birth weight. Hence, this study aimed to assess the survival status and predictors of mortality among low birth weight neonates. Methods: An institutional-based retrospective cohort study design was conducted among 718 low birth weight neonates admitted to the neonatal intensive care unit from January 1, 2017, to December 30, 2019, at Felege Hiwot Comprehensive Specialized Hospital. Data were entered into Epi data version 3.1 and analyzed with STATA version 14. Kaplan-Meier curves together with a Log rank test were used to estimate the survival time and showed the presence of differences among groups. Cox proportional-hazard regression was used to estimate the hazard ratio at the 5% level of significance to determine the net effect of each explanatory variable on survival status. Results: The overall incidence density was 35.3 per 1000 person-day observations (CI: 30.8 −40.6) with 5715 follow-up days. Deliveries outside the health institution [AHR; 2.31 (95% CI: 1.20-4.42)], maternal age <18 years [AHR; 3.08 (95% CI: 1.64-5.81)] and maternal age >35 years [AHR; 3.83 (95% CI: 2.00-7.31)], neonatal sepsis [AHR; 2.33 (95% CI: 1.38-3.94)], neonatal respiratory distress syndrome [AHR; 1.92 (95% CI: 1.27-2.89)], necrotizing enterocolitis [AHR; 3.09 (95% CI: 1.69-5.64)] and birth weight <1000 gm [AHR; 3.61 (95% CI: 1.73-7.55)] were found to be significant predictors. Conclusion: This study showed that two of the seven low birth weight neonates died during the follow-up period. Therefore, it is better for health care providers and other stakeholders to focus more on early diagnosis and management of low birth weight neonates with sepsis, respiratory distress syndrome, necrotizing enterocolitis and counseling mothers on the risk of having a child in early and old age.
BMC Pediatrics, 2015
Background: Health protocols need to be guided by current data on survival and benefits of interventions within the local context. Periodic clinical audits are required to inform and update health care protocols. This study aimed to review morbidity and mortality in very low birth weight (VLBW) infants in 2013 compared with similar data from 2006/2007. Methods: We performed a retrospective review of patients' records from a neonatal computer database for 562 VLBW infants. These neonates weighed between 500 and 1500 g at birth, and were admitted within 48 hours after birth between 01 January 2013 and 31 December 2013. Patients' characteristics, complications of prematurity, and therapeutic interventions were compared with 2006/2007 data. Univariate analysis and multiple logistic regression were performed to establish significant associations of various factors with survival to discharge for 2013. Results: Survival in 2013 was similar to that in 2006/2007 (73.4% vs 70.2%, p = 0.27). However, survival in neonates who weighed 750-900 g significantly improved from 20.4% in 2006/2007 to 52.4% in 2013 (p = 0.001). The use of nasal continuous positive airway pressure (NCPAP) increased from 20.3% to 62.9% and surfactant use increased from 19.2% to 65.5% between the two time periods (both p < 0.001). Antenatal care attendance improved from 54.4% to 70.6% (p = 0.001) and late onset sepsis (>72 hours after birth) increased from 12.5% to 19% (p = 0.006) between the two time periods. Other variables remained unchanged between 2006/2007 and 2013. The main determinants of survival to discharge in 2013 were birth weight (odds ratio 1.005, 95% confidence interval 1.003-1.0007, resuscitation at birth (2.673, 1.375-5.197), NCPAP (0.247, 0.109-0.560), necrotising enterocolitis (4.555, 1.659-12.51), and mode of delivery, including normal vaginal delivery (0.456, 0.231-0.903) and vaginal breech (0.069, 0.013-0.364). Conclusions: There was a marked improvement in the survival of neonates weighing between 750 and 900 g at birth, most likely due to provision of surfactant and NCPAP. Provision of NCPAP, prevention of necrotising enterocolitis, and control of infection need to be prioritised in VLBW infants to improve their outcome.
Intisari Sains Medis, 2020
Background: Sepsis is one of the most common causes of mortality and long terms morbidity among infants. It is known to be related to Low Birth Weight (LBW) due to the lack of immunity function to resist the infection. This study aims to identify the characteristics of neonatal sepsis in LBW infants in Sanglah General Hospital. Method: A retrospective cross-sectional study was conducted in the Neonatal Care Unit, Sanglah General Hospital, during January-December 2018 period among 135 neonates. Samples were taken using total sampling for neonates who had LBW and diagnosed with sepsis. Uncompleted data and voluntarily discharge patients were excluded from the study. Data regarding baseline characteristics of respondents, major and minor risk factors, laboratory results of sepsis, as well as blood culture, were analyzed using SPSS version 23 for Windows. Result: Most of respondents were male (54.1%), followed by bodyweight 1,500-2,499 grams (58.5%), and preterm labor (<32 weeks) (86.7%). The average length of stay was 21.30± 19.28 days. The vast majority of infants diagnosed as Early Onset Sepsis (EONS) (89.6%). Most of the patients had normal leukocyte count (93.3%), neutrophilia (95.6%), low I/T ratio (70.4%), normal platelets (67.4%), and high procalcitonin (98.5%). The blood culture showed the most microorganism was Enterococcus faecalis (6.00%) in grampositive bacteria. Conclusion: This study found that most of the respondents were male, followed by preterm labor, EONS, normal leukocyte count, low I/T ratio, high procalcitonin, as well as Enterococcus faecalis as the most common gram-positive bacteria.
Research Square (Research Square), 2023
BACKGROUND: Sepsis is one of the leading causes of mortality and morbidity among neonates. Neonatal sepsis (NS) contributes to 44% of 5.4 million under-5 mortalities globally, and 12% of neonatal deaths in Uganda in 2020 were attributed to NS. Early risk factor identi cation and improved obstetric care are proven to reduce deaths due to NS, yet there is scanty literature for the Lango sub-region. We, therefore, determined the prevalence of NS, and identi ed the factors associated with NS in the Lango sub-region of northern Uganda. METHODS: A hospital-based, quantitative, cross-sectional study with a retrospective chart review was conducted in the neonatal intensive care unit (NICU) at Lira regional referral hospital (LRRH), in northern Uganda, among 194 records of neonates admitted to the NICU from September 2022 to February 2023. The participant records were selected by systematic sampling technique and a structured data extraction tool was used to collect data. Using SPSS version 25 data entry and analysis were done. The univariate analysis gave a general description of the data. Using logistic regression analysis associations were measured and the statistical signi cance was declared at a P value of 0.05 after multivariate analysis. RESULTS: Among a total of 194 neonates whose charts were reviewed, 80% of these had neonatal sepsis, giving a prevalence of 41.2%. Age in days of the neonate (AOR=4.212[1.627-10.903]) for neonates of 1-3days of age, sex where males (AOR=2.09[1.123-3.887]), an APGAR score of 1-4 at birth (AOR= 0.309, 95% CI: [0.115-0.831]) and weight at birth <2500g (AOR=2.543[1.381-4.683]) were signi cantly related to NS.
Intisari Sains Medis, 2020
Backgrounds: Neonatal sepsis is a significant cause of mortality and long-term morbidity. The preterm infant has high-risk sepsis and its sequelae. Low birth weight infants were more susceptible to sepsis. Initial infections in neonates may not be identified due to non-specific symptoms and sign with the limited laboratory criteria. This study aims to describe the characteristics of neonatal sepsis in low birth weight infants in the neonatology intensive care unit of Sanglah Hospital.Methods: A retrospective cross-sectional study was conducted among 168 infants aged zero to 28 days with birth weights <2,500 grams from May 2017 – April 2018 at Sanglah General Hospital, Bali, Indonesia using a purposive sampling technique. The inclusion criteria were sepsis infants who were hospitalized in neonatology care rooms during the study period at Sanglah General Hospital. Variables assessed in this study were sex, location and mode of delivery, birth weight, gestational age, number of pa...
Clinical Profile of Low Birth Weight Neonates Admitted in NICU: A Hospital Based Study
Journal of Medical Science And clinical Research
Background: LBW is defined by as weight at birth of less than 2500gm irrespective of gestation. The most important marker for adverse perinatal and neonatal outcome is the birth weight. There is increased risk of mortality among low birth weight by 2-3 times as compared to normal birth weight babies due to infection. So, this study aims at identifying the clinical profile of Low birth weight neonates in a rural tertiary care hospital. Method: Prospective hospital based study was conducted on 100 neonates with low birth weight(less than 2500gm) admitted in Neonatal intensive care unit (NICU) of department of Pediatrics, Maharishi Markandeshwar Institute of medical science and research(MMIMSR) Mullana-ambala (Haryana) from September 2015 to October 2016.. Maternal and neonatal risk factors were recorded. The study was designed to assess the clinical profile of LBW babies. All neonates less than 2500gms irrespective of gestational age, were examined and a detailed history was obtained and recorded in a predesigned Proforma. Results: Out of 100 neonates, seventy four (74%) were categorized as low birth weight neonates, twenty four (24%) as very low birth weight and two (2%) were extremely low birth weight. Seventy two (72%) of enrolled group were appropriate for gestational age and twenty eight (28%) were small for gestational age. Majority of the neonates were born at a gestational age of 34-36 weeks. Blood group of both mother and newborn was analysed. Maximum of the mothers were found to be O+ve (n=20) blood group and newborns of B+ve (n=18) blood group. Neonatal hyperbilirubinenia (32%) was the leading cause requiring admission followed by Prematurity (25%) sepsis (18%), respiratory distress syndrome (15%) and birth asphyxia (10%). Conclusion: Most of low birth babies are AGA babies. Neonatal hyperbilirubinemia (NNHB) and Prematurity were the leading cause requiring admission. Hence antenatal programs to prevent prematurity and low birth weight babies should be strengthened.
Asian Journal of Paediatric Research , 2019
Background: About 45% of deaths among under-fives occur during the neonatal period with a high contribution from preterm infant deaths. Regular evaluation of preterm deaths is important as patterns and therefore intervention may vary at different times and places. Objectives: To determine the common causes of illness and death among preterm infants admitted to the Special Care Baby Unit (SCBU) of the University of Port Harcourt Teaching Hospital (UPTH), over a 5 year period. Methods: This was a retrospective review of data of preterm babies admitted to the SCBU from 2012-2016. Information obtained included biodata, nature of illness, duration of admission and outcomes. Data were collated and analyzed using SPSS v20 for windows. Results: 3,071 babies were admitted in SCBU over the period, of which 683 (22.2%) were preterms. Of these, 421 (61.6%) were inborn while 262 (38.4%) were out-born. The male: female ratio was 0.9:1. Morbidity patterns varied with birth asphyxia (20%) ranking highest among in-borns while sepsis (21%) and neonatal jaundice (15%) were more prominent in out-borns. The overall preterm mortality rate was 24.6 % with rates being significantly higher in out-born 30.5% versus inborn 20.9% (p=0.004). Mortality was highest among low birth weight preterms. Admission rates decreased steadily over the period. Original Research Article Briggs et al.; AJPR, 1(2): 1-7, 2018; Article no.AJPR.47154 2 Conclusion: Birth asphyxia and sepsis were the main morbidities recorded. Mortality rates were higher among outborns. Low birth weight preterms were most affected because they were in the majority. There was a steady decline in admission rates. Improving obstetric care, neonatal resuscitation, infrastructure and subsidizing healthcare services for preterms is needful.
Burden of disease and risk factors for mortality amongst hospitalized newborns in Nigeria and Kenya
2021
Objective To describe the patient population, priority diseases and outcomes in newborns admitted <48 hours old to neonatal units in both Kenya and Nigeria. Study design In a network of seven secondary and tertiary level neonatal units in Nigeria and Kenya, we captured anonymised data on all admissions <48 hours of age over a 6-month period. Results 2280 newborns were admitted. Mean birthweight was 2.3 kg (SD 0.9); 57.0% (1214/2128) infants were low birthweight (LBW; <2.5kg) and 22.6% (480/2128) were very LBW (VLBW; <1.5 kg). Median gestation was 36 weeks (interquartile range 32, 39) and 21.6% (483/2236) infants were very preterm (gestation <32 weeks). The most common morbidities were jaundice (987/2262, 43.6%), suspected sepsis (955/2280, 41.9%), respiratory conditions (817/2280, 35.8%) and birth asphyxia (547/2280, 24.0%). 18.7% (423/2262) newborns died; mortality was very high amongst VLBW (222/472, 47%) and very preterm infants (197/483, 40.8%). Factors independen...