Current Trends in Neonatal Morbidity and Mortality: Experiences from a Tertiary Center in Lagos, Nigeria

Introduction: The most vulnerable period of human life is neonatal period, which accounts for most of the morbidities and mortalities. Most of them are preventable with adequate health-care facilities. Objectives: The aim of the study was to determine the trends of neonatal mortality and identify the risk factors, most of which are preventable and measure the progress of health-care services. Methods: A retrospective study was conducted in neonatal intensive care unit (NICU) of Al-Ameen Children Hospital (AMCH) Vijayapura, Karnataka, India. Data were extracted from paper medical records at AMCH of a period of 1 year and digitized. Data obtained included age, sex and birth weight, place of delivery, morbidity profile, mortality profile, diagnosis, and period of stay in NICU. Results: A total of 648 neonates were admitted in NICU during the study period of 1-year duration, between January and December 2021. A total of 382 (58.9%) infants were discharged on recovery, 65 (10.3%) were referred due to unavailability of advanced surgical intervention, 39 (6%) were discharged against medical advice, 162 (25%) died due to various reasons. Male neonatal deaths outnumbered female neonates (56.8%). Among the total neonatal deaths, 82 (50.6%) were preterm neonates, 73 (45.1%) were term neonates and 7 (4.3%) were post-term neonates. It was noticed that among neonatal deaths, 87 (54.3%) babies were out-born and 75 (46.2%) babies were inborn. In this study, it was noticed that the mortality percentage of the neonate falling in the category of 1.5–1.9 kg was high compared to other categories. In our study, respiratory distress syndrome was the main cause of mortality accounting for 19.1% (31 cases) of total cases and prematurity was the most common risk factor. Conclusion: Improving the standard of antenatal care and encouraging deliveries in institutions having good NICU facility and early identification of risk factors help to reduce the mortality and its complications.

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“…Highest mortalities in neonates were observed with low birth weight and pre-term babies, similar to the study conducted by Fajolu et al [9].…”

Section: Discussionsupporting

confidence: 89%

Risk factors and trends in neonatal mortality in NICU in a tertiary care hospital in India

Ukkali¹,

Kulkarni²,

Badsheshi³

et al. 2024

Indian J Child Health

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“…At the Cairo University NICU in Egypt, mortality from NJ decreased from 25% in 2008 to 10% in 2015, again attributable to the combination of several interventions including protocols, training of personnel, and innovative technology ( 33 ). Lastly, NJ as a cause of neonatal death at a teaching hospital in Lagos, Nigeria, decreased from 23.3% in 2001 ( 34 ) to 11.5% in 2020 ( 35 ).…”

Section: Introductionmentioning

confidence: 98%

Management challenges in the treatment of severe hyperbilirubinemia in low- and middle-income countries: Encouraging advancements, remaining gaps, and future opportunities

Satrom

Farouk²,

Slusher³

2023

Front. Pediatr.

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Neonatal jaundice (NJ) is common in newborn infants. Severe NJ (SNJ) has potentially negative neurological sequelae that are largely preventable in high resource settings if timely diagnosis and treatment are provided. Advancements in NJ care in low- and middle-income countries (LMIC) have been made over recent years, especially with respect to an emphasis on parental education about the disease and technological advancements for improved diagnosis and treatment. Challenges remain, however, due to lack of routine screening for SNJ risk factors, fragmented medical infrastructure, and lack of culturally appropriate and regionally specific treatment guidelines. This article highlights both encouraging advancements in NJ care as well as remaining gaps. Opportunities are identified for future work in eliminating the gaps in NJ care and preventing death and disability related to SNJ around the globe.

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“…ABE is common and a frequent cause of neonatal death 9 – 14 in regions where glucose-6-phosphate dehydrogenase deficiency (G6PDd) 14 – 17 and out-of-hospital births 7 , 12 , 16 , 18 are prevalent. Timely care seeking is critical since most neonates with ABE are already symptomatic when admitted to institutions capable of treating severe hyperbilirubinemia.…”

Section: Introductionmentioning

confidence: 99%

Antenatal jaundice instruction and acute bilirubin encephalopathy in Nigeria

Wennberg,

Imam,

Shwe

et al. 2023

Pediatr Res

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Background Acute Bilirubin Encephalopathy (ABE) is common in Nigeria. Parents’ inability to recognize jaundice and delays in seeking care are significant barriers to its prevention. Methods We compared associations of (1) interactive antenatal maternal jaundice instruction with postnatal reinforcement, (2) standard postnatal instruction, and (3) no maternal instruction with the incidence of ABE among 647 jaundice admissions stratified for risk factors identified in initial descriptive analysis. Results Eighty-three (83/647;12.8%) admissions developed ABE including eleven jaundice-related deaths. ABE was present at admission in 20/22 (90.9%) if mothers received no jaundice instruction and no antenatal care, 42/182 (23.1%) if received antenatal care but no instruction, 16/95 (16.8%) if received postnatal instruction only, and 4/337 (1.2%) if mothers received both antenatal and postnatal instruction (p < .001). ABE was highly associated with out-of-hospital delivery, number of antenatal clinic visits, and birth attendant, but these risks were mitigated by antenatal/postnatal instruction. Admission rates with bilirubin levels below treatment guidelines (12 mg/dL) were higher following instruction (30.7%) than with no instruction (14.4%). Limiting subjects to those meeting admission criteria increased ABE rates in all groups without altering conclusions. Conclusion Interactive antenatal instruction with postnatal reinforcement resulted in timely care seeking and a lower incidence of ABE. Impact Empowering mothers to participate in neonatal jaundice management is critical in low-income countries where jaundice monitoring and follow up are unreliable. Instructing mothers about jaundice in antenatal clinics with postnatal reinforcement is more effective than standard postpartum instruction in facilitating jaundice detection, timely care seeking, and lowering the incidence of acute bilirubin encephalopathy (ABE). Antenatal training also mitigates risks for ABE associated with out-of-hospital deliveries, limited antenatal care, and unskilled birth attendants. Impact: Adding structured jaundice instruction in antenatal clinics could greatly reduce bilirubin induced brain injury in countries where ABE is common.

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Current Trends in Neonatal Morbidity and Mortality: Experiences from a Tertiary Center in Lagos, Nigeria

Cited by 4 publications

References 30 publications

Risk factors and trends in neonatal mortality in NICU in a tertiary care hospital in India

Risk factors and trends in neonatal mortality in NICU in a tertiary care hospital in India

Management challenges in the treatment of severe hyperbilirubinemia in low- and middle-income countries: Encouraging advancements, remaining gaps, and future opportunities

Antenatal jaundice instruction and acute bilirubin encephalopathy in Nigeria

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