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Background Prematurity is a major cause of neonatal morbidity and mortality. The aim of this study is to assess the rate of prematurity and determine the mortality rate and short-term outcomes among premature infants admitted at King Abdullah University Hospital (KAUH) in Jordan. Materials and methods A retrospective cross-sectional review of all premature infants admitted at KAUH between August 2016 and August 2018 was conducted. Collected data include characteristics, medical interventions, morbidities, mortality, and discharge outcomes. Included infants were divided into two groups: less than 32-week gestation (group 1) and ≥32-week gestation (group 2). The outcomes were compared between both groups and reported accordingly. Results Out of 7020 newborns, 1102 were delivered before 37-week gestation, representing a prematurity rate of 15.7%. The mean gestational age and birth weight were 33.8 weeks and 2116 grams respectively. Group 1 comprised 13%. Late preterm infants (gestational age 34 to 36 6/7 weeks) accounted for 74%. The mortality rate was 4.6%. More infants died from group 1 (29% vs. 1.5%, p < 0.05). Group 1 infants had higher rates of respiratory distress syndrome (92% vs. 30%), bronchopulmonary dysplasia (28.4% vs. 1.1%), severe intraventricular hemorrhage (5.9% vs. 0.1%), high-stage retinopathy of prematurity (6.6% vs. 0.2%), necrotizing enterocolitis (9.2% vs. 0%), and sepsis (18.4% vs. 2.1%). At discharge, there was a significant difference in the length of stay, corrected gestational age, and weight in favor of group 2 (p < 0.05). Conclusions Although high rate of prematurity was observed, the majority were late preterm with reassuring outcomes. Compared with >32-week infants, the mortality and short-term complications were more frequent among those born before 32 weeks. Still, the overall mortality rate and risk of morbidities were reasonable. Population-based analysis of the risk factors among the more vulnerable very preterm and extremely premature infants is recommended to better understand the outcomes.
Background Prematurity is a major cause of neonatal morbidity and mortality. The aim of this study is to assess the rate of prematurity and determine the mortality rate and short-term outcomes among premature infants admitted at King Abdullah University Hospital (KAUH) in Jordan. Materials and methods A retrospective cross-sectional review of all premature infants admitted at KAUH between August 2016 and August 2018 was conducted. Collected data include characteristics, medical interventions, morbidities, mortality, and discharge outcomes. Included infants were divided into two groups: less than 32-week gestation (group 1) and ≥32-week gestation (group 2). The outcomes were compared between both groups and reported accordingly. Results Out of 7020 newborns, 1102 were delivered before 37-week gestation, representing a prematurity rate of 15.7%. The mean gestational age and birth weight were 33.8 weeks and 2116 grams respectively. Group 1 comprised 13%. Late preterm infants (gestational age 34 to 36 6/7 weeks) accounted for 74%. The mortality rate was 4.6%. More infants died from group 1 (29% vs. 1.5%, p < 0.05). Group 1 infants had higher rates of respiratory distress syndrome (92% vs. 30%), bronchopulmonary dysplasia (28.4% vs. 1.1%), severe intraventricular hemorrhage (5.9% vs. 0.1%), high-stage retinopathy of prematurity (6.6% vs. 0.2%), necrotizing enterocolitis (9.2% vs. 0%), and sepsis (18.4% vs. 2.1%). At discharge, there was a significant difference in the length of stay, corrected gestational age, and weight in favor of group 2 (p < 0.05). Conclusions Although high rate of prematurity was observed, the majority were late preterm with reassuring outcomes. Compared with >32-week infants, the mortality and short-term complications were more frequent among those born before 32 weeks. Still, the overall mortality rate and risk of morbidities were reasonable. Population-based analysis of the risk factors among the more vulnerable very preterm and extremely premature infants is recommended to better understand the outcomes.
Purpose: To review the indications and clinical profile of neonatal admissions at King Abdullah University Hospital in Jordan. Materials and Methods: We conducted a cross-sectional review of all neonates admitted to the neonatal intensive care unit between September 2016 and September 2018. Collected data include demographic characteristics, indications for admission, morbidities and mortality, and discharge outcomes. Findings were reported among term and preterm infants. Results: A total of 1444 infants were admitted during the study period of whom 1332 (92.2%) were inborn and 612 (42.4%) were term neonates. Of the 832 preterm infants, 545 were late preterm (34-36 6/7 gestation) and 125 had very low birth weight (˂ 1500 grams); 925 (64%) were born by cesarean section. Respiratory failure of the newborn (41.2%) and prematurity (33.3%) were the main indications for admission among the whole cohort. Maternal prolonged premature rupture of membranes (PROM) was observed in nearly half the admissions of term infants. Hypoxic ischemic encephalopathy (3.2% vs 0.7%, p 0.01) and congenital anomalies (5% vs 1.2%, p 0.03) were more common in term infants. The rate of bronchopulmonary dysplasia was 39% among <28-week and 28% among <32-week premature infants. Sepsis was encountered in 59 infants. The overall mortality rate was 3.8%. Prematurity was the main predisposing factor for mortality (Adjusted OR: 9.9, 95% CI: 3.5, 27.6). Conclusion: The majority of neonatal admissions at our institution are term and late preterm infants delivered by cesarean section. Prematurity, respiratory failure of the newborn, and suspected sepsis due to maternal PROM are the leading causes of admission. The mortality rate is within WHO target to achieve Sustainable Development Goal 3. Populationbased studies are needed to make better conclusions that represent the whole Jordanian population. A revisit for the indications of cesarean deliveries may help to improve the neonatal outcomes.
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