Prematurity, asphyxia and congenital malformations underrepresented among neonates in a tertiary pediatric hospital in Vietnam

BMC Pediatrics

Freddy K Pedersen¹  Gorm Greisen¹  Lone G Stensballe⁴  Cam N Phuong³  Binh TT Ho³  Alexandra Y Kruse² 

[1] Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark;International Child Health Research Unit, JMC, Rigshospitalet – Copenhagen University Hospital, Copenhagen, Denmark;Neonatal Intensive Care Unit, Children’s Hospital 1, Ho Chi Minh City, Vietnam;Department of Pediatrics and Adolescent Medicine, JMC, Rigshospitalet – Copenhagen University Hospital, Copenhagen, Denmark

关键词: Vietnam;    Newborn;    Neonate;    Mortality;    Lower middle income country, morbidity;    Hospitalization;    Health care access;    Developing country;   

Others  :  1170585
DOI  :  10.1186/1471-2431-12-199

 received in 2012-06-13, accepted in 2012-12-21,  发布年份 2012

【 摘 要 】

Background

Estimated 17,000 neonates (≤ 28 days of age) die in Vietnam annually, corresponding to more than half of the child mortality burden. However, current knowledge about these neonates is limited. Prematurity, asphyxia and congenital malformations are major causes of death in neonates worldwide. To improve survival and long term development, these vulnerable neonates need access to the specialized neonatal care existing, although limited, in lower middle-income countries like Vietnam. The aim of this study was to describe these conditions in a specialized Vietnamese hospital, compared to a Danish hospital.

Methods

We performed a comparative observational study of all neonates admitted to a tertiary pediatric hospital in South Vietnam in 2009–2010. The data were prospectively extracted from the central hospital registry and included basic patient characteristics and diagnoses (International Classification of Diseases, 10^th revision). Prematurity, asphyxia and designated congenital malformations (oesophageal atresia, gastroschisis, omphalocoele, diaphragmatic hernia and heart disease) were investigated. In a subgroup, the prematurity diagnosis was validated using a questionnaire. The hospitalization ratio of each diagnosis was compared to those obtained from a Danish tertiary hospital. The Danish data were retrieved from the neonatal department database for a ten-year period.

Results

The study included 5763 neonates (missing<1%). The catchment population was 726,578 live births. The diagnosis was prematurity in 7%, asphyxia in 2% and one of the designated congenital malformations in 6%. The diagnosis of prematurity was correctly assigned to 85% of the neonates, who were very premature or had very low birth weight according to the questionnaire, completed by 2196 neonates. Compared to the Danish Hospital, the hospitalization ratios of neonates diagnosed with prematurity (p<0.01), asphyxia (p<0.01) and designated congenital malformations (p<0.01- 0.04) were significantly lower.

Conclusion

Our findings suggest the investigated diagnoses were underrepresented in the Vietnamese study hospital. In contrast, relatively mild diagnoses were frequent. These results indicate the use of specialized care may not be optimal. Pre-hospital selection mechanisms were not investigated and additional studies are needed to optimise utilisation of specialized care and improve neonatal survival.

【 授权许可】

   
2012 Kruse et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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