Post Discharge Outcome of Preterm Infants in a Low-Middle-Income Country

Abstract

Background:The improvement of postnatal care has led to the increase in survival rate of preterm infants in our setting and considering their vulnerability, we set out to assess the morbidity and mortality of preterm infants 12 months after discharge from the neonatal intensive care unit (NICU). Methods: A retrospective cohort study was done from the 2008 to 2013 at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital and included children born preterm, admitted in the NICU and discharged alive during the study period. Results: Out of 816 premature infants that were discharged alive from the NICU, only 232 (28.4%) preterm infants discharged alive presented for the routine visits during the first 12 months of life. Among these, 206 (89%) had at least one complication during the neonatal hospitalization period. Postnatal complications were significantly more frequent in infants born before 34 weeks of gestation and in babies with birth weight below 1500 grams (p<0.001). Up to 72.5% of those who came for routine visits were less than 34 weeks and 86% weighed <2000 g at birth. Seventy-six (32.7%) preterm infants were readmitted within their first year of life and the causes of readmission were respiratory tract diseases in 42 (55%), late neonatal sepsis in 19 (25.0%), malaria in 9 (11.8%) and epilepsy in 6 (7.9%). Neither the gestational age nor birth weight influenced readmission (p=0.25, p=0.590 respectively). The smaller the gestational age, the longer the duration of postnatal hospitalization (p<0.001). Conclusion: Routine follow-up after discharge remains a problem in our setting due to non-respect of appointments. Infants born preterm suffer mostly from respiratory tract diseases during the first year of life.