Complementary feeding is most frequently initiated earlier than 6 months in this population. Good breastfeeding practices may influence timely initiation of complementary feeding. Interventions should be targeted at the entire population irrespective of educational and socioeconomic status.
Background: The incidence of neonatal macrosomia is on the increase in many parts of the world. The impact of the condition on baby and child health has not received adequate research attention.
Objective: To determine the prevalence, baby and maternal characteristics, the pattern of neonatal morbidity and perinatal outcome of macrosomia.
Methods: A retrospective study of all singleton deliveries with birth weight ≥ 4.0 kg was conducted at a tertiary facility in the south-western part of Nigeria between January 2013 and December 2014.
Results: Eighty-eight newborn babies were macrosomic out of 1854 deliveries, resulting in a prevalence rate of 4.7%. The male-to-female ratio was 1: 0.54, while the mean (±SD) birth weight was 4.23 ± 0.29 kg. There was no significant difference in the mean birth weights of the male and female babies (t = 1.24, p = 0.218). The mean maternal age was 31.7 ± 5.1 years. Multiparous mothers had the highest proportion of macrosomic babies, while a majority of mothers (77.3%) were either overweight or obese. One-minute Apgar score <7 was observed among 28 (31.8%) babies. Twenty-three (26.1%) babies were hospitalized for further management. Birth asphyxia, hypoglycaemia and hyperbilirubinaemia were the leading morbidities. The perinatal mortality rate for macrosomic babies was 102.2 per 1000 total births.
Conclusion: The incidence of neonatal macrosomia is relatively low in our study population but falls within the range of prevalence rates reported from other parts of the country. Birth asphyxia, hypoglycaemia and hyperbilirubinemia are common morbidities among affected babies.
The incidence and pattern of morbidities among HEU infants showed no relation to the mode of feeding. Rather, family SES and the use of antiretroviral drugs were predictors of morbidities among HEU infants.
Background: Perinatal and neonatal mortality rates have been described as sensitive indices of the quality of health care services. Regular audits of perinatal and neonatal mortalities are desirable to evaluate the various global interventions.Objective: To describe the current pattern of perinatal and neonatal mortality in a Nigerian tertiary health facility.Methods: Using a prospective audit method, the socio-demographic parameters of all perinatal and neonatal deaths recorded in a Nigerian tertiary facility between February 2017 and January 2018 were studied.Results: There were 1,019 deliveries with stillbirth rate of 27.5/1000 total births and early neonatal death (END) rate among in-born babies of 27.2/1000 live births. The overall perinatal mortality rate for in-facility deliveries was 53.9/1000 total births and neonatal mortality (till the end of 28 days) rate of 27.2/1000 live births. Severe perinatal asphyxia and prematurity were the leading causes of neonatal deaths while obstructed labour and intra-partum eclampsia were the two leading maternal conditions related to stillbirths (25.0% and 21.4% respectively).Gestational age < 32 weeks, age < 24 hours and inborn status were significantly associated with END (p = 0.002, p <0.001 and p = 0.002 respectively).Conclusion: The in-facility perinatal mortality rate was high though stillbirth rate was relatively low. There is a need to improve the quality of emergency obstetric and neonatal services prior to referral to tertiary facilities.Keywords: Asphyxia, neonatal death, obstructed labour, perinatal death, stillbirth.
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