Morbidity and mortality patterns of preterm low birthweight neonates admitted to referral hospitals in the Amhara region of Ethiopia: retrospective follow-up study

Abstract

ObjectiveThis study aimed to assess the morbidity and mortality patterns of preterm neonates with low birth weight admitted in the Amhara region referral hospitals in Ethiopia.DesignHospital-based retrospective follow-up study.SettingAmhara region referral hospitals, Ethiopia.ParticipantsA total of 291 preterm neonates low birth weight that were admitted to referral hospitals in the Amhara region between 1 January 2017 and 30 December 2018 were reviewed. Data were entered into Epi-data V.4.4.2.1 and exported to STATA V.14 for analysis, and variables with a p value of <0.05 at 95% confidence level in multivariable logistic regression model analysis were declared as statistically significant associated factors of mortality.Primary outcomeMorbidity and mortality patterns in preterm low birthweight neonates.ResultsThis study revealed that 37.8% (95% CI 32.4% to 43.5%) of preterm low birthweight neonates died. The most common morbidities found were 219 (75.26%) hypothermia, followed by 201 (69.07%), 145 (49.83%), 39 (13.4%) and 24 (8.25%) with sepsis, respiratory distress, jaundice and congenital anomalies, respectively. Sepsis (AOR: 2.0; 95% CI 1.03 to 3.89), respiratory distress (AOR: 4.6; 95% CI 2.51 to 8.40), hypoglycaemia (AOR 3.91; 95% CI 1.09 to 10.52), APGAR score at fifth minute <7 (AOR 0.39; 95% CI (0.18 to 0.82) and duration of hospital stay below mean (<9.82 days) (AOR 0.17; 95% CI 0.09 to 0.33) were associated with mortality.ConclusionThe mortality rate of preterm low birthweight neonates was high, indicating that this is a public health issue. Hypothermia, sepsis, respiratory distress, jaundice and congenital anomalies were the common morbidities. Sepsis, respiratory distress, hypoglycaemia, Apgar score at fifth minute <7 and duration of hospital stay below the mean were independent factors of mortality. However, these need to be further investigated in future research and appropriately addressed using prospective follow-up.

Incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first seven days in Northwest Ethiopia Comprehensive Specialized Hospitals, 2023: A retrospective follow-up study

“…Accordingly, this study found that at the end of the follow-up 47.16% (95% CI 42.80% to 52.55%) of neonates developed RDS. This finding was aligned with studies conducted in Thailand (44.15%),37 and Ethiopia 49.8 3%,38 The possible justification is due to similarities in study design, sample size and the presence of similar maternal health problems. On the other hand, this study was higher than two different studies conducted in Pakistan 11%–12.8%,15 16 India 38%,39 Nepal 21.4%40 and Nigeria 10.9% 19.…”

“…Due to this, the synthesised surfactant is not adequate to maintain alveolar stability, and this leads to atelectasis, and the neonate develops RDS 32 33 50. In addition, premature neonates are more vulnerable to different medical problems such as hypothermia, hypoglycaemia, sepsis, NEC and other comorbidities while this increases the probability of developing RDS 38 42…”

Length of Hospital Stay and Factors Associated Very Low Birth Weight Preterm Neonates Surviving to Discharge a cross-sectional study, 2022

“…The discrepancy was reportedly caused by a variation in the discharge criteria and the determination of fetal viability in our setting (> 28 weeks). a research done on morbidity and mortality patterns of preterm low birthweight neonates admitted to referral hospitals in the Amhara region in Ethiopia showed mean length of hospital stay was 9.82 days which was lower than this study (9). This was because the study participant included in the study were low birth weight preterm neonates (birth weight < 2500gm) and the sample size was also larger as compared to the current study.…”

“…Studies also showed as length of hospital stay of preterm neonate increased the hazard of time to death (8). On the other hand, when a very low birth weight preterm neonate stayed less than the median length of hospital stay, there would be associated increase mortality (9). Some studies showed prolonged and continuous exposure to noise and bright lights for preterm neonates had a negative impact on future neurocognitive development (10,11).…”