Factors influencing survival and short-term outcomes of very low birth weight infants in a tertiary hospital in Johannesburg

Author:

Ingemyr Kristin,Elfvin Anders,Hentz Elisabet,Saggers Robin T.,Ballot Daynia E.

Abstract

BackgroundThe neonatal mortality rate in South Africa is lower than the global average, but still approximately five times higher than some European and Scandinavian countries. Prematurity, and its complications, is the main cause (35%) of neonatal deaths.ObjectiveTo review the maternal, delivery period and infant characteristics in relation to mortality in very low birth weight (VLBW) infants at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).MethodsThis was a retrospective descriptive study of VLBW infants admitted to CMJAH between 1 January 2017 and 31 December 2018. All infants with a birth weight between 500 to ≤ 1,500 grams were included. The characteristics and survival of these infants were described using univariate analysis.ResultsOverall survival was 66.5%. Provision of antenatal steroids, antenatal care, Cesarean section, female sex, resuscitation at birth, and 5-min Apgar score more than five was related with better survival to discharge. Among respiratory diagnoses, 82.8% were diagnosed with RDS, 70.8% received surfactant therapy and 90.7% received non-invasive respiratory support after resuscitation. At discharge, 59.5% of the mothers were breastfeeding and 30.8% spent time in kangaroo mother care.ConclusionThe two-thirds survival rate of VLBW infants is similar to those in other developing countries but still remains lower than developed countries. This may be improved with better antenatal care attendance, coverage of antenatal steroids, temperature control after birth, improving infection prevention and control practices, breastfeeding rates and kangaroo mother care. The survival rate was lowest amongst extremely low birth weight (ELBW) infants.

Funder

Adlerbertska Research Foundation

Publisher

Frontiers Media SA

Subject

Pediatrics, Perinatology and Child Health

Reference25 articles.

1. Under-five mortality rate 20172017

2. The Millennium Development Goals Report 20152015

3. Reducing neonatal deaths in South Africa: progress and challenges;Rhoda;S Afr Med J,2018

4. Neonatal Mortality 2017

5. Levels & Trends in Child Mortality Report 20192019

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