Moses Musooko1, Othman Kakaire2, Annettee Nakimuli2, Sarah Nakubulwa2, Jolly Nankunda3, Michael O Osinde4, Scovia N Mbalinda5, Nelson Kakande6, Dan K Kaye2. 1. Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. Electronic address: bamusooko@yahoo.com. 2. Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. 3. Department of Pediatrics and Child Health Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. 4. Department of Obstetrics and Gynecology, Jinja Regional Hospital, Jinja, Uganda. 5. Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda. 6. Clinical, Operations and Health Services Research Program, Joint Clinical Research Centre, Kampala, Uganda.
Abstract
OBJECTIVE: To determine the incidence and risk factors for early neonatal death among newborns with severe perinatal morbidity. METHODS: A prospective cohort study was performed of 341 newborns with severe perinatal morbidity admitted to the neonatal intensive care unit of Mulago Hospital, Uganda. All newborns were followed up for 7 days or until time of death. Information surrounding the mother's obstetric history and pregnancy, the birth, and the neonatal history was collected using an interviewer-administered questionnaire and by review of relevant records. Multivariate logistic regression analysis was performed to assess factors independently associated with early neonatal death. RESULTS: A total of 37 (10.9%) neonates died within 7 days, giving an incidence of early neonatal death of 109 deaths per 1000 live births (3 per 100 person-days). In multivariate analysis, respiratory distress (adjusted risk ratio [aRR] 31.29; 95% CI, 4.17-234.20; P=0.001) and inadequate fetal heart monitoring during labor (aRR 6.0; 95% CI 1.40-25.67; P=0.016) were significantly associated with an increased risk of early neonatal death. CONCLUSION: Approximately one in 10 neonates with severe perinatal morbidity died within 7 days of birth. Respiratory distress and poor monitoring of labor were risk factors for early neonatal death.
OBJECTIVE: To determine the incidence and risk factors for early neonatal death among newborns with severe perinatal morbidity. METHODS: A prospective cohort study was performed of 341 newborns with severe perinatal morbidity admitted to the neonatal intensive care unit of Mulago Hospital, Uganda. All newborns were followed up for 7 days or until time of death. Information surrounding the mother's obstetric history and pregnancy, the birth, and the neonatal history was collected using an interviewer-administered questionnaire and by review of relevant records. Multivariate logistic regression analysis was performed to assess factors independently associated with early neonatal death. RESULTS: A total of 37 (10.9%) neonates died within 7 days, giving an incidence of early neonatal death of 109 deaths per 1000 live births (3 per 100 person-days). In multivariate analysis, respiratory distress (adjusted risk ratio [aRR] 31.29; 95% CI, 4.17-234.20; P=0.001) and inadequate fetal heart monitoring during labor (aRR 6.0; 95% CI 1.40-25.67; P=0.016) were significantly associated with an increased risk of early neonatal death. CONCLUSION: Approximately one in 10 neonates with severe perinatal morbidity died within 7 days of birth. Respiratory distress and poor monitoring of labor were risk factors for early neonatal death.
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