Early mortality and associated factors among preterm neonates admitted at public regional referral hospitals in Dar es Salaam, Tanzania.
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Date
2024
Authors
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Publisher
Kairuki University
Abstract
Background: Approximately 22% of neonates in Tanzania are born prematurely which increases the possibility of early death. However, the early mortality of preterm birth and associated factors are not well understood. This study was conducted to determine the early clinical outcome and associated factors among preterm neonates born in Regional Referral Hospitals in Dar es Salaam, Tanzania. Understanding the magnitude and the associated factors can lead to improvement in quality of care with subsequent reduction of mortality among preterm neonates.
Objectives: The broad objective of the study was to determine the early mortality and associated factors among preterm neonates born in Regional Referral Hospitals in Dar es Salaam, Tanzania
Methodology: This was a descriptive longitudinal study conducted in Dar es Salaam Regional Referral Hospitals. Participants were enrolled consecutively after meeting the eligibility criteria and were followed-up for seven days post-delivery to determine early neonatal outcome. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 28.0 (IBM SPSS Statistics for Windows, Armonk,
NY: IBM Corp). Chi-square test or Fisher's exact test were used to compare categorical variables while binary logistic regression was used to identify factors associated with early mortality among the preterm neonates.
Results: A total of 216 preterm neonates who were enrolled in the study were involved in final data analysis. Among these, 35 (16.2%) neonates died within the first seven days of life. The most common causes of deaths were respiratory distress syndrome in 21 (61.8%) neonates and sepsis in 8 (23%) neonates. Seventy-two (33.3%) neonates were admitted due to respiratory distress syndrome and anaemia. The presence of hypoglycaemia (AOR=3.4 (1.08–10.94 and p-value =0.04); extreme and very low birth weight (AOR=5.56 (1.36–22.67 and p value=0.02) and need for resuscitation at birth (AOR=7.4 (1.2-44.5 and p-value =0.03) were factors associated with early neonatal mortality.
Conclusions: The magnitude of early neonatal mortality among preterm neonates was relatively high with respiratory distress syndrome and sepsis being the leading causes of mortality. Additionally, extreme and very low birth weight; hypoglycaemia and need for resuscitation at birth were the factors associated with early neonatal mortality.
Recommendations: To reduce early neonatal deaths, it is important to quickly
identify and treat respiratory distress syndrome and sepsis in preterm babies.
Additionally, focusing on babies with extreme- and very low birth weight, low blood
sugar, and those needing help to initiate spontaneous breathing at birth can improve the chances of survival.
Description
A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Medicine in Paediatrics and child health.
Keywords
preterm neonate, respiratory distress syndrome, neonatal sepsis
Citation
Malenda, R.M., 2024. Early mortality and associated factors among preterm neonates admitted at public regional referral hospitals in Dar es Salaam, Tanzania. Kairuki University