Birthweight and gestational age-specific neonatal mortality rate in tertiary care facilities in Eastern Central
Paul Mubiri1,2, Harriet Nambuya3, Darious Kajjo1,2
1Makerere University School of Public Health College of Health Sciences Kampala Uganda.
Insights
Neonatal mortality in Uganda decreases with increasing birthweight, but survival rates are highest for infants between 3500-3999g. Further research is needed to understand newborn survival across diverse birthweight and gestational age categories.
Area of Science:
- Neonatal Health
- Perinatal Epidemiology
- Global Health
Background:
- Neonatal deaths constitute 45% of under-five mortality globally, with 2.8 million annual deaths.
- Limited data exists on birthweight and gestational age-specific mortality in low-resource settings like Uganda.
- Understanding these factors is crucial for developing effective interventions to reduce neonatal mortality.
Purpose of the Study:
- To investigate the relationship between birthweight, gestational age, and pre-discharge mortality in Ugandan tertiary care facilities.
- To analyze mortality rates based on specific birthweight and gestational age categories.
- To identify patterns in newborn survival within a large cohort.
Main Methods:
- Utilized secondary data from the East Africa Preterm Birth Initiative study (October 2016 - March 2019).
- Included infants with gestational age ≥24 weeks and/or birthweight ≥500g.
- Employed multivariable Poisson regression to determine birthweight and gestational age-specific mortality rates.
Main Results:
- Analyzed 50,278 birth records, with 95.3% live births.
- Overall pre-discharge mortality was 13.0 per 1000 live births.
- Mortality decreased with increasing birthweight up to 3500-3999g (4.7/1000), then increased slightly for heavier infants (>4500g: 11.2/1000).
Conclusions:
- The study underscores the critical impact of birthweight on neonatal mortality in Uganda.
- Optimal survival is observed in the 3500-3999g birthweight range.
- Further research is essential to elucidate newborn survival across varied birthweight and gestational age strata.
Background:
An estimated 2.8 million neonatal deaths occur each year globally, which accounts for at least 45% of deaths in children aged less than 5 years. Birthweight and gestational age-specific mortality estimates are limited in low-resource countries like Uganda. A deeper analysis of mortality by birthweight and gestational age is critical in identifying the cause and potential solutions to decrease neonatal mortality.
Objectives:
We studied mortality before discharge in relation to birthweight and gestational age using a large sample size from selected tertiary care facilities in Uganda.
Methods:
We used secondary data from the East Africa Preterm Birth Initiative study conducted in six tertiary care facilities. Birth records of infants born between October 2016 and March 2019 with a gestational age greater than or equal to 24 weeks and/or birthweight greater than or equal to 500 g were reviewed for inclusion in the analysis. Newborn death before discharge was the outcome variable of interest. Multivariable Poisson regression modeling was used to explore birthweight and gestational age-specific mortality rate.
Results:
We analysed 50 278 birth records. Among these 95.3% (47 913) were live births and 4.8% (2365) were stillbirths. Of the 47 913 live births, 50% (24 147) were males. Overall, pre-discharge mortality was 13.0 per 1000 live births. For each 1 kg increase in birthweight, mortality before discharge decreased by -0.016. As birthweight increases, the mortality before discharge decreased from 336 per 1000 live births among infants born between 500 and 999 g, to 4.7 per 1000 live births among infants born weighing 3500 to 3999 g, and increased again to 11.2 per 1000 live births among infants weighing more than 4500 g.
Conclusions:
Our study highlights the need for further research to understand newborn survival across different birthweight and gestational categories.
