Birthweight and gestational age‐specific neonatal mortality rate in tertiary care facilities in Eastern Central Uganda

Abstract

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.

Impact of respiratory distress syndrome and birth asphyxia exposure on the survival of preterm neonates in East Africa continent: systematic review and meta-analysis

“…The studies were conducted from 2012 to 2020 among more than 11 Eastern Africa countries including 12 from Ethiopia represented by 14 studies [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. Tanzania [ 14 , 45 , 46 , 47 ] and Uganda [ 12 , 48 , 49 , 50 ] represented by 04 studies, Besides, Burundi [ 51 , 52 ] and Eretria [ 53 , 54 ] represented by 02 studies. While Malawi [ 55 ], Kenya [ 56 ], Zambia [ 24 ], Sudan [ 25 ], Mozambique [ 57 ], and Zimbabwe [ 58 ] are represented by 01 studies.…”

“…While Malawi [ 55 ], Kenya [ 56 ], Zambia [ 24 ], Sudan [ 25 ], Mozambique [ 57 ], and Zimbabwe [ 58 ] are represented by 01 studies. Regarding study design, 13 studies employed retrospective cohort [ 12 , 14 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 56 , 57 ], whereas 07 prospective cohort studies [ 31 , 32 , 46 , 47 , 48 , 49 , 50 ], 01 case-control type [ 36 ], and 11 cross-sectional design [ 24 , 25 , 33 , 34 , 35 , 51 , 52 , 53 , 54 , 55 , 58 ]. All studies included in this review were observational studies which were conducted in the hospital with sample sizes ranging from 100 participants reported from a study in Ethiopia and Sudan [ 25 , 36 ], and 29811 from Uganda [ 12 ] respectively ( Table 1 ).…”

“…Globally, 13 million preterm were born annually and the highest percentage resource-limited setting [ 11 ], and eastern Africa countries have a lion sharing of this burden [ 10 , 12 , 13 , 14 ]. Besides, a global action report 2020 showed that the preterm birth rate was 11%, and millions of children died due to preterm birth before the age of 5 years.…”

Early Neonatal Mortality Profile in Dr. Soetomo General Hospital

“…A study in Uganda states that for every 1,000 grams increase in birth weight, the risk of mortality decreases by 0.016. This Uganda study also states that the mortality rate is highest for babies born with birth weights between 500-999 grams (336/1000 live births) (Mubiri et al, 2020). In Indonesia, a study found that the risk for neonatal mortality is 9.89 times higher for babies with low birth weight (Suparmi et al, 2016).…”