Neonatal Death in Low Birth Weight Infants in Basrah Maternity & Children Hospital at 2008

  • Aida Abdul Kareem ( Department of Pediatrics / College of Medicine / University of Basrah )
  • Basim Abdul Kareem Abdul Hassan
Keywords: Low birth weight, Prematurity, small for gestational age, neonatal deaths Basrah

Abstract

 

Background :

Low birth weight) less than 2500 grams) that includes preterm birth and small for gestational age, is regarded as important causes of neonatal deaths and contributes to 60% to 80% of all neonatal deaths.

Objectives :

to assess the frequency of deaths in low birth weight neonates and it’s  relation to selected neonatal, labour and maternal characteristics.

Patients and Methods :

A prospective study was carried out on low birth weight newborns admitted to neonatal care units in Basrah Maternity and Children Hospital for four months( from 1st of  February till the end of the May 2008) on 508 newborns  with low birth weight out of 1338 neonates admitted during the study period. One hundered-ninty one (191) neonates with low birth weight died, their death was studied in relation to neonatal, labour, delivery and maternal characteristics from data collection by special questionnaire.

Results :

It was found that (68.95%) of total deaths had low birth weight, male to female ratio was (1.4:1). The death was significantly related to gestational age, weight, growth status (being small for gestational age) and male sex. (P value was<0.001). The most common causes of deaths were respiratory distress syndrome (54.97%) followed by sepsis (19.37%. Other neonatal characteristics like postnatal referral, early death, and hospitalization period of less than seven days, need for resuscitation at time of birth and multiple pregnancies were associated with increased risk of death. (P value <0.001).Hospital delivery, non-complicated delivery and normal vaginal deliveries were associated with decreasing neonatal mortalities.(P value <.001).Young age mothers (less than twenty years), Primgravidae, those who had anemia in pregnancy or had poor antenatal care were more liable to have neonatal death ,while mortality rate was significantly lower among breastfed neonates compared to formula fed babies.

Conclusions :

The frequency of low birth weight and their deaths were high, the death was related to weight, gestational age, growth status, early neonatal period, complicated labour, caesarean section, young primi mother and maternal anemia. Prevention of prematurity and intrauterine growth retardation causes by good antenatal care, skilled attendance at births, and availability of surfactant therapy can reduce mortality.

References

- WHO publication /2014 .WHA Global Nutrition Targets 2025: Low Birth Weight Policy Brief

- WHO publication. WHO Media center. Care of the preterm and/or low-birth-weight newborn.Factsheet.January 2016. E-mail: mediainquiries@who.int

- WHO publication. WHO Media center. Newborns: reducing mortality. Fact sheet January 2016. E-mail: mediainquiries@who.int

-Nazar P Shabila, Hamdia M Ahmed, Maryam Y Yasin. Women’s views and experiences of antenatal care in Iraq: a Q methodology study. BMC Pregnancy and Childbirth 2014; 14:43

- Michael S. Kramer and Cesar G.victora. Low Birth Weight and Mortality. In Richard D. Semba MD, MPH, Martin W. Bloem MD, PhD, Peter Piot MD, PhD Nutrition and Health in Developing countries.. Human Press Inc., Totawa,NJ Nutrition and Health Series .2008

-Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics . 2010 Sep; 126(3)

- Rosa Maria Soares Madeira Domingue, Maria do Carmo Le, Zulmira Maria de Araújo Hartz, Marcos Augusto Bastos Dias, Marcelo Vianna Vettore. Access to and utilization of prenatal care services in the Unified Health System of the city of Rio de Janeiro, Brazil. Rev. Bras. epidemiol. 2013 Dec; 16(4).

-Ahmad MO, Kalsoom U, Sughra U, Hadi U, Imran M.-J. Effect of maternal anemia on birth weight. Ayub Med Coll Abbottabad. 2011 Jan-Mar; 23(1):77-99

-K Jagadish Kumar, N Asha, D Srinivasa Murthy, MS Sujatha, and VG Manjunath. Maternal Anemia in Various Trimesters and its Effect on Newborn Weight and Maturity: An Observational Study. Ayesha. Int J Prev Med. 2013 Feb; 4(2): 193–199

- Steer PJ hemoglobin concentration and birth weight Maternal.Am J Clin Nutr. 2000 May;71(5 Suppl):1285S-7S.

- Bassuni W, Abbag F, Asindi A, Al Barki A, Al Binali A M. Neonatal deaths in the Asir region of Saudi Arabia experience in a referral neonatal intensive care unit .Annals of Saudi Medicine 1997;17( 5) :12-14.

- keshtkaran A, Keshtkaran V. Factors Affecting Neonatal Death in Fars Province, Southern Iran, 2004. Middle East Journal of Family Medicine 2007; 5 (1):12-14.

- Hong R., Beltran M. Low birth weight as a risk factor for infant mortality in Egypt. Eastern Mediterranean Health Journal 2008; 14(5):22-23.

- Parmar V R ,Grover N , Randhawa I, Bahl L. , Kaushal RK ,et al. Perinatal Mortality In Shimla. Indian Pediatrics 1994; 31:834-836.

- Banajeh S M, Al-Rabee A M, Al-Arashi IH. Burden of perinatal conditions in Yemen: a 12-year hospital-based study. Eastern Mediterranean Health Journal. 2005. May; 11 (4): 22-23.

- Stoll BT. The High risk pregnancy In: Robert M. Kliegman, MD, Bonita M.D. Stanton, MD, Joseph St. Geme, MD and Nina F Schor, MD, PhD. Nelson`s textbook of pediatrics. 20th edition, Philadelphia. WB Saunders Co, Elsevier 2015; 684-708

- Osahaki R, Nakamora K. Factors Effecting Short Term Mortality in Japan. Tohoko J.Exp.Med. 2005; 20(5): 141.

-Shrestha M, Manandhar DS, Dhakal S. Two year audit of perinatal mortality at Kathmandu Medical College Teaching Hospital. Kathmandu University Medical Journal 2006; 4(2) :176-181.

-Quaderi S, Higiazi S. Causes of Infant Death in Jordan. Amman (JO): Higher Council of Science and Technology Final Report: 2003; 5: 3-4.

-World Health Organization. Reducing Perinatal and Neonatal Mortality. Child Health Research Project Special Report 1999 Oct; 3-9.

- Gagliardi L, Cavazza A, Brunelli A, Battaglioli M. Assessing mortality risk in very low birthweight infants: a comparison of CRIB, CRIB-II, and SNAPPE-II. Arch. Dis. Child. Fetal Neonatal Ed. 2004; 89: 419-422.

- Donald D M, Steven L, Brianm C, Casey B, Kenneth J ,et al. Birth Weight In Relation To morbidity and Mortality Among Newborn Infants. The New England Journal of Medicine. 1999 April; 340 (16):1- 2.

-Grandi C., Tapia J, Marshall G. An assessment of the severity, proportionality and risk of mortality of very low birth weight infants with fetal growth restriction a multicenter South American analysis. Journal of Pediatric 2005; 81(3):198-201.

- Apeawusu B A, Cecil A K. A Case-Control Study Of Early Neonatal Deaths At The Port Moresby General Hospital To Determine Associated Risk Factors. Png Med J 2002; 45(3-4):185-196.

- McIntosh N, Stenson B. Newborn .In: McIntosh Helms P, Smyth R (eds).Forfar and Arneil’s textbook of pediatrics 6thed .Philadelphia. Churchill Livingstone Co 2003:178-179.

-Thilo E H, Rosenberg A A. Evaluation of the newborn infant. In: William W. Hay Jr, et al By McGraw-Hill Education. Current Pediatric Diagnosis & Treatment 16th Ed: - Europe 2002:14-25.

- Alma M, Rebecca S. Abnormalities of Fetal Growth. In: Taeusch, Ballard, Gleason (eds). Avery’s Diseases of the Newborn. 8th edition, Elesvier Saunders .2004: 32-39.

-Ojha N, Malla D S. Low Birth Weight at Term Relationship with Maternal Anthropometry. J Nepal Med Assoc 2007; 46: 52-56.

- Mokhtar M M, Abdel-Fattah M M. Consanguinity and Advanced Maternal Age as Risk Factors for Reproductive Losses in Alexandria, Egypt. European Journal of Epidemiology 2001; 17: 559-565.

Published
2019-04-30
Section
Articles