Causes of neonatal admissions and deaths at a rural hospital in KwaZulu-Natal, South Africa

Abstract

One of the Millennium Development Goals (MDG-4) is to reduce child mortality by up to two-thirds by 2015. In most developing countries, a higher proportion of neonatal deaths are observed. We quantify the causes of neonatal morbidity and mortality at a rural hospital. A retrospective review of consecutive neonatal admissions to Empangeni Hospital, between January and December 2005, was conducted. Of 1,573 admissions, male babies made up 57.8% of admissions and 63% of the deaths. The most common causes of admission were birth asphyxia (38.2%), prematurity (23.5%), and infection (21%). The average length of stay was 9.2 days (SD 12 days). The overall mortality rate was 13.8% but higher (23.4%) among the referred babies. Admission and death rates of low birthweight babies (<2,500g) were 53% and 84%, respectively. Two-thirds (67.7%) of those babies who died were born preterm. Over half (56.6%) of the deaths took place within the first three days of life. Logistic regression showed that extremely low birthweight (OR=13.923, 95% CI:5.759; 33.656), male sex of the babies (OR=1.633, 95% CI:1.132; 2.356), and preterm delivery (OR=2.975, 95% CI: 1.296; 6.836) were significant predictors of neonatal death. A substantial proportion of neonatal mortality occurs in the hospital neonatal unit. Asphyxia, prematurity, low birthweight and neonatal infection are the leading cause of neonatal hospitalisation and deaths. Several simple and effective interventions exist to minimise neonatal admissions and deaths in South Africa.Peer reviewed.

Morbidity and Mortality Among Neonates Admitted to a Neonatal Intensive Care Unit of a Tertiary Care Teaching Hospital of Jammu and Kashmir (India)

“…The type of diseases contributing to mortality in our study are similar to type of diseases observed by other studies conducted at different places nationally and internationally by Nahar, et al [14], Anjum, et al [10], Prasad, et al [26], Hoque, et al [25], Seyal, et al [12], Narayan [19], Ali, et al [27].…”

“…The neonatal mortality (9.73%) in NICU of SKIMS Srinagar is similar to a study conducted by Sarkar, et al [9,11,12,17,22,23,[25][26][27][28][29][30][31][32]. Low neonatal mortality rates were found by Sankaran, et al [33] (4%) and Zullini, et al…”

“…Studies by Anjum, et al [10] and Hoque, et al [25] have found that birth asphyxia is the most common cause of neonatal mortality.…”

The First Sixty Minutes in Preterm Neonates’ Life: Predicted Morbidities and Interventions

“…Hypothermia prevention before neonatal transportation leads to a better outcome [11][12][13]. The distance during neonatal transportation is considered an insignificant factor in comparison with hypothermia stabilization [11].…”

“…Since the head constitutes a major portion of the body surface area in neonates and the brain plays the role of a prime heat-generating organ, head covering has been an effective technique in preventing temperature reduction in neonates [14]. But all these techniques are still insufficient in very preterm neonates.Ambient temperature of delivery room: According to WHO's recommendation the temperature of delivery rooms' should be adjusted at no less than 25°C, while the International Liaison Committee on Resuscitation (ILCOR) 2010 recommends that it should be ≥ 26 °C [3][4][5][6][7][8][9][10][11][12][13][14][15]. However, these suggestions aren't feasible targets.…”