Early outcomes of preterm neonates with respiratory distress syndrome admitted at Muhimbili National Hospital, a prospective study

BMC Pediatrics

Research

Judith Cosmas¹  Augustine Massawe²  Karim Manji²  Maria Bulimba³  Yaser Abdallah³ 

[1] Department of Paediatrics and Child Health, Muhimbili National Hospital, P.O BOX 65000, Dar es Salaam, Tanzania;Department of Paediatrics and child health, Muhimbili University of Health and Allied Sciences, P.O BOX 65001, Dar es Salaam, Tanzania;Department of Paediatrics and child health, Muhimbili University of Health and Allied Sciences, P.O BOX 65001, Dar es Salaam, Tanzania;Department of Paediatrics and Child Health, The Aga Khan Hospital, P.O BOX 2289, Dar es Salaam, Tanzania;

关键词: Prematurity;    Respiratory distress syndrome;    Mortality;   

DOI  :  10.1186/s12887-022-03731-2

 received in 2022-07-19, accepted in 2022-11-02,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundRespiratory distress syndrome (RDS) is one of the commonest complication preterm neonates suffer and accounts for a significant morbidity and mortality in low and middle income countries (LMICs). Addressing RDS is therefore crucial in reducing the under 5 mortality in LMICs. This study aimed at describing early outcomes (death/survival) of preterm neonates with RDS and identify factors associated with the outcomes among neonates admitted at Muhimbili national hospital, Tanzania.MethodsBetween October 2019 and January 2020 we conducted a prospective study on 246 preterm neonates with RDS at Muhimbili National Hospital. These were followed up for 7 days. We generated Kaplan–Meier survival curve to demonstrate time to death. We performed a cox regression analysis to ascertain factors associated with outcomes. The risk of mortality was analyzed and presented with hazard ratio. Confidence interval of 95% and P-value less than 0.05 were considered as significant.ResultsOf the 246 study participants 51.6% were male. The median birth weight and gestational age of participants (Inter-Quartile range) was 1.3 kg (1.0, 1.7) and 31 weeks (29, 32) respectively. Majority (60%) of study participants were inborn. Only 11.4% of mothers of study participants received steroids. Of the study participants 49 (20%) received surfactant. By day 7 of age 77/246 (31.3%) study participants had died while the majority of those alive 109/169 (64.5%) continued to need some respiratory support. Factors independently associated with mortality by day 7 included birth weight of < 1500 g (AHR = 2.11 (1.16–3.85), CI95%; p = 0.015), lack of antenatal steroids (AHR = 4.59 (1.11–18.9), CI95%; p = 0.035), 5th minute APGAR score of < 7 (AHR = 2.18 (1.33–3.56), CI95%; p = 0.002) and oxygen saturation < 90% at 6 hours post admission (AHR = 4.45 (1.68–11.7), CI95%; p = 0.003).ConclusionOur study reports that there was high mortality among preterm neonates admitted with RDS mainly occurring within the first week of life. Preterm neonates with very low birth weight (VLBW), whose mother did not receive antenatal steroid, who scored < 7 at 5th minute and whose saturation was < 90% at 6 hours were at higher risk of dying. There is need to scale up antenatal corticosteroids, neonatal resuscitation training and saturation monitoring among preterm neonates with RDS.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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