Risk factors for mortality of preterm infants in the neonatal medicine department of the ‘Mère-Enfant’ University Hospital Centre of Libreville
DOI:
https://doi.org/10.18203/2349-3291.ijcp20230074Keywords:
Prematurity, Mortality factors, UHCME-JEF, Libreville, GabonAbstract
Background: Reducing neonatal mortality of preterm infants is a public health priority in developing countries. The objective of this study was to study the risk factors for mortality of preterm infants in the neonatology department of UHCME-JEF.
Methods: A retrospective, analytical study was done over 36 months (January 2019-December 2021) in the neonatology department of UHCME-JEF. Maternal and newborn parameters were studied. All hospitalized preterm newborns were included.
Results: The prevalence of prematurity was 44.6%. The mortality rate was 18.7%. The mean age of mothers was 28.05±6.5 years. They were unemployed (69.4%) and single (73.6%). The three main causes of death were sepsis (41.7%), respiratory failure (26.0%), and anoxic-ischemic encephalopathy (15.3%). The risk factors associated with death were multiparity [p=0.001, OR=2.0, IC 95% (1.32-3.00)], pre-existing maternal diabetes [p=0.007, OR=2.4, IC 95% (1.31-4.52)], prenatal check-up not done [p=0, 024, OR=1.5 IC 95% (1.04-2.05)], GA<28SA [p<0.001, OR=1.8 IC 95% (1.24 -2.71)], Apgar <3 at the first [p=0.036, OR=1.8, IC 95% (1.21-2.76)] and fifth minute [p=0.010, OR=3.2, IC 95% (1.35-7.74)] resuscitation at birth [p=0.017, OR=1.5, IC 95% (1.04-2.05)], birth weight <1000 g (p=0.001, OR=2.8, IC 95% (1.92-4.23)], hypotonia [p=0.001, OR=1.6, IC 95% (1.23-2.32)], asphyxia [p=0.020, OR=1.7 CI 95% (1.09-2.55)], hypothermia [p<0.001, OR=2.1, CI 95% (1.56-2.86)], the presence of thrombocytopenia [p=0.001, OR=1.9, CI 95% (1.62-2.93)] and glycemic dysregulation [p=0.001, OR=2.8, CI 95% (2.09-3.73)].
Conclusions: The mortality of preterm newborns remains a major problem in our department. It is necessary to promote good surveillance of pregnancy, and correct care of premature infants in the delivery room and hospitalization.
References
WHO. Preterm birth, 2022. Available at: https://www.who.int/newsroom/factsheets/detail/preterm-birth. Accessed on 12 December 2022.
Chang HH, Larson J, Blencowe H, Spong CY, Howson CP, Cairns-Smith S, et al. Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index. Lancet. 2013;381(9862):223-34.
Nations Unies. 17 objectifs pour sauver le monde, 2022. Disponible sur https=//www.un.org/sustainabledevelopment/fr/objectifs-de-developpement-durable/. Accessed on 12 December 2022.
Nyenga MA, Mwananteba A, Kanteng AW. Profile and risk of mortality in premature infants at Sendwe-Lubumbashi hospital, Democratic Republic of Congo. Rev Ped Fleuve Congo. 2013; 1=29-37.
Kuissi E, Minto’o S, Minko JI, Koumba R, Koko J, Ategbo S. Epidemiological, Clinical and Evolutive Aspects of Preterm Neonates at the University Hospital of Angondje – Gabon. ContROL. 2018;1:2.
Minko JI, Vierin-Ntsame Y, Luis T, Wassef Wassef S, Effame Eya E, Koko J. Profile and risk factors of mortality in premature new-borns at the University Hospital Center of Libreville Gabon. BMO. 2017; 15(43)=6-16.
Egesa WI, Odong RJ, Kalubi P, Ortiz YEA, Atwine D, Turyasiima M, et al. Preterm Neonatal Mortality and Its Determinants at a Tertiary Hospital in Western Uganda: A Prospective Cohort Study. Pediatric Health Med Ther. 2020;11:409-20.
Ouédraogo YSO, Kaboré R, Koueta F, Dao L, Nacro B, Kam L. Risk factors for death of low birth weight new-borns in Ouagadougou (Burkina Faso). 2013; 26(4):204-9.
Nguele S, Gongnet K, Gabkika BM, Toralta J, Granga DD, Youssouf D, et al. Factors associated with the survival of preterm infants at the Mother and Child Hospital of N'Djamena in Chad. African J Pediat Med Genet. 2018;4:15-21.
Diouf FN, Faye PM, Gueye M, Ba ID, Guisse AL, Thiam L, et al. Socio-demographic, epidemiological, clinical and prognostic aspects of prematurity in the neonatology unit of the Albert Royer Children's Hospital in Dakar/Senegal. Rev Cames health. 2016;4(2):19-24.
Chiabi A, Mah EM, Mvondo N, Nguefack S, Mbuagbaw L, Kamga KK, et al. Risk factors for premature births: a cross-sectional analysis of hospital records in a Cameroonian health facility. Afr J Reprod Health. 2013;17(4):77-83.
Hounkponou NFM, Tonato BA, Ahouingnan AY, Gbevo S, Laourou H, Vodouhe M, et al. Frequency and factors associated with preterm deliveries at the University and Departmental Hospital Center of Borgou Alibori in Benin. Eur Science J. 2017;13(24):427-35.
Radhanpuri F, Desai DA, Sharma J, Kaur P. Preterm birth and its outcome. Int J Reprod Contracept Obstet Gynecol. 2014;3:153-57.
Hug L, Alexander M, You D, Alkema L. National, regional and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030= a systematic analysis. Lancet Glob Health. 2019;7:710-20.
Lacroze V. Prematurity definitions, epidemiology, etiopathogenesis, organization of divisions. J Pediatric Pueric. 2015;28:47-55.
Chanie ES, Alemu AY, Mekonen DK, Melese BD, Minuye B, Hailemeskel HS, et al. Impact of respiratory distress syndrome and birth asphyxia exposure on the survival of preterm neonates in East Africa continent systematic review and meta-analysis. Heliyon. 2021;7(6).
Aynalem YA, Mekonen H, Akalu TY, Gebremichael B, Shiferaw WS. Preterm neonatal mortality and its predictors in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia= a retrospective cohort study. J Health Sci. 2021;31(1):43-5.
Jain K, Sankar MJ, Nangia S, Ballambattu VB, Sundaram V, Ramji S, et al. Causes of death in preterm neonates (<33 weeks) born in tertiary care hospitals in India: analysis of three large prospective multicentric cohorts. J Perinatol. 2019;39(1):13-9.
Olack B, Santos N, Inziani M, Moshi V, Oyoo P, Nalwa G, et al. Causes of preterm and low birth weight neonatal mortality in a rural community in Kenya: evidence from verbal and social autopsy. BMC Pregnancy Childbirth. 2021;21(1):536.
Yu X, He C, Wang Y, Kang L, Miao L, Chen J, et al. Preterm neonatal mortality in China during 2009-2018: A retrospective study. PLoS One. 2021;16(12):e0260611.
OMS. Naissances prématurées = principaux faits, 2018. Available at: https=//www.who.int/fr/news-room/fact-sheets/detail/preterm-birth. Accessed on 12 December 2022.
Joy E. Zupan J. Series MDGs and new-born babies. Lancet. 2015;365:891-900.
Lassi ZS, Salam RA, Das JK, Bhutta ZA. Essential interventions for maternal, new-born and child health: background and methodology. Reprod Health. 2014;11(1):S1.
