Thesis (M.Med. (Paediatrics and Child Health)) -- University of Limpopo, 2019 / Objectives
To determine the prevalence and survival rate; and to assess the maternal risk
factors as well as complications of prematurity, associated with the mortality of very
low and extremely low birth weight infants in the Neonatal Intensive Care Unit
(NICU) of Mankweng Hospital.
Materials and Methods
A retrospective descriptive study was conducted at the NICU of Mankweng Hospital
for a 7-month period from 1st January to 31st July 2015. The patient medical records
and the Perinatal Problem Identification Programme (PPIP) data were used for the
study.
Results
Prevalence of prematurity was 23%, Infants weighing between 500g-1499g
represented 6.3% of the total live births and 25% of the admissions to the NICU; of
which 4.9% were classified as extremely low birth weight (ELBW). Overall 77% of
the study population survived until discharge. From the medical records, the survival
to discharge of infants with weight 500g - 999g was 52%; and 84% for those with
weight 1000g-1499g. Multivariable analysis found that improved survival was associated with an increase in gestational age (p <0.001), as well as birth weight (p <0.001) and prolonged length of stay. Variables associated with poor survival were spontaneous preterm labour (p = 0.031), low Apgar score at 1 and 5 minutes (p <0.001), sepsis (p = 0.001), respiratory distress syndrome (p <0.001), pulmonary hemorrhage (p <0.001),
hypothermia (P = 0.005), resuscitation at birth (p = 0.002) and necrotising
enterocolitis (p =0.044). Antenatal steroids were not associated with survival (p
=0.111), however this was not documented in 53%(134/252) of the records, so the
non-significance to outcome in this study may not be a true reflection. The use of NCPAP or SiPAP only was associated with improved survival of up to 69% and high mortality rates were recorded in babies who required invasive ventilator support. Multi-organ immaturity was found to be the most common cause of death, followed by sepsis.
Conclusion: The prevalence and survival rates of very low and extremely low birth
weight, found in this study are comparable to those found in other tertiary hospitals in
South Africa. The survival rate of ELBW babies is low and must be improved.
Reliable data and further research should address effective steps to prevent preterm
labour, extreme prematurity and hypothermia. The documentation and provision of
antenatal steroids is encouraged.
KEY CONCEPTS: Prematurity, Extremely low and Very low birth weight, Risk
factors, Prevalence, Survival, Neonatal mortality rate.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/2930 |
| Date | January 2019 |
| Creators | Mashego, M. P. A |
| Contributors | Shipalana, N. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | xvi, 58 leaves |
| Relation |
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