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Preterm Babies: Management and Challenges Associated with Survival in a Resource-Limited Setting
M Bello1, S Pius1, B A Ibrahim1
1Department of Paediatrics, College of Medical Sciences, University of Maiduguri,Nigeria.
Insights
Improved survival rates for preterm infants, particularly those with very low birth weights, present new management challenges. Limited access to incubator care and essential treatments like caffeine and surfactant impacts outcomes for these vulnerable newborns.
Area of Science:
- Neonatalogy
- Pediatric Critical Care
- Public Health
Background:
- Preterm birth poses significant challenges due to high mortality and long-term disabilities.
- Bronchopulmonary dysplasia is a prevalent disability among preterm survivors.
- Rising disability rates necessitate improved management strategies for preterm infants.
Purpose of the Study:
- To assess the survival and management challenges of preterm infants at the University of Maiduguri Teaching Hospital.
- To identify factors influencing the outcomes of preterm babies in a resource-limited setting.
Main Methods:
- Retrospective analysis of 714 preterm infant case notes from the Special Care Baby Unit (SCBU).
- Data collected included birth weight, in-born vs. out-born status, and duration of medical interventions.
- Statistical analysis to determine associations between interventions and survival outcomes.
Main Results:
- A retrieval rate of 63% for case notes was achieved.
- The majority of preterm infants (64.1%) were out-born.
- While oxygen therapy and phototherapy showed no survival association, incubator care duration was significantly linked to improved outcomes (p=0.005).
Conclusions:
- Preterm infant survival has improved, with 32.70% of the studied population surviving.
- Improved survival, especially for extreme and very low birth weight infants, highlights challenges in accessing critical care.
- Limited availability of incubator care, caffeine, and surfactant may influence the outcomes of these high-risk preterm infants.
Background:
Preterm babies have constituted a major constraints on human and material resources due to early mortality and long term disability among survivors. Rates of disability among survivors have increased over the period, with high rates of broncho-pulmonary dysplasia.
Objective:
To determine the survival and management challenges of preterm babies in University of Maiduguri Teaching Hospital, Maiduguri Borno State REUSLTS: Of the 1129 preterm babies managed in the Special Care Baby Unit (SCBU), 714 cases notes were retrieved and analyzed giving a retrieval rate of 63%. There were 256 (35.9%) preterm babies as in-born, while 458 (64.1%) were out-born. Male preterm babies were 372 (52.1%), while female preterm babies were 342 (47.9%); with female to male ratio of 1.08:1. Extreme low birth weight (<1000grams) were 17 (2.3%), very low birth weight (1000-1499 grams) were 288 (40.3%) while low birth weight (1500-2499 grams) were 406 (56.9%). We also documented 3 preterm babies whose weights >2500 grams were large for gestational age weight. Duration of oxygen therapy (p = 0.620), duration of phototherapy (p = 0.474), and EBT (p = 0.466) showed no association with their survival while only duration of incubator care (p = 0.005) demonstrated significant association with outcome.
Conclusion:
The population of preterm babies studied is 32.70% and their survival has remarkably improved. However, this improved survival of preterm babies especially the extreme and very low birth weight categories has posed a big challenge due to limited access to incubator care, use of caffeine and surfactant which might influence the outcome.
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