Analysis On Survival Rate Of Premature And Critically Sick New-Born Babies Admitted At Windhoek Central Hospital (Wch), Namibia

ABSTRACT

Introduction: Prematurity is the major cause of neonatal death world-wide, Namibia included. In Namibia, the neonatal mortality has increased dramatically from 19 deaths per 1000 live births in 2000 to 30 deaths per 1000 live birth in 2014. Objectives: To determine the survival rate of premature and critically sick new-born babies and assess the risk factors associated with death of these babies (premature babies – are babies born before 37 weeks of gestation, counting from the first day of the Last Menstrual Period (LMP); critically sick new-born babies – are babies born with life-threatening birth defects such as gastrointestinal, heart and lung conditions, as well as other complex diseases that require intensive care. ) in the Neonatal Intensive Care Unit (NICU) of Windhoek Central Hospital (WCH), Namibia from 1st January 2018 – 31st December 2018. To analyse the data obtained according to birth weight, gestational age, risk factors and causes of death. Method: The study was a hospital based cross-sectional retrospective chart review analysis; files for all premature babies known admitted and discharged at WCH NICU from 1st January 2018 to 31st December 2018 were analysed. The Statistical Package for Social Sciences (SPSS), Version 25 was used to analyse the data and Kaplan Meier survival estimator was used to estimate the survival rate of premature and critically sick new-born infants. Results: A total of 509 available files for infants admitted at Windhoek Central Hospital – Neonatal Intensive Care Unit (NICU) were analysed. Overall, a high survival rate was observed (68.4% survived, 31.6% died). Low survival rates were observed in lower gestational ages (GA) (1. extremely premature and 2. very premature category) and lower birth weight (1. ELBW and 2. SLBW), 74.3% and 42.5% non-survivors in lower GA category and 92.9% and 43.7% for lower birth weight respectively. Fifty percent of infants referred from district hospitals (referrals) did not survive and the percentage of survivors versus resuscitation given are: 36.2% (n = 177) placed on ventilator; 48.5% (n = 101) given surfactant; 60.1% (n = 278) oxygen therapy; 66.1% (n = 387) put on Continuous Positive Airway pressure (CPAP); 71.7% (n = 184) on phototherapy. Page VII of 87 While for those given antibioticsthe followings survival rates were obtained: L1- 67.9%; (n = 190) L2 - 64.4% (n = 45); L3 – 50% (n = 2); L1 + L2 – 63.5% (n = 85); L1 + L2 + L3 – 56.7% (n = 30). Conclusion: The survival rate of premature and critically sick new-born babies in our study was high (68.4%), similar to the findings from comparable studies in other resource-limited settings. Our findings suggest respiratory distress syndrome, sepsis, and asphyxia are the main causes of death of premature and critically sick new-born babies. The findings also concluded that the lower the gestational age and birth weight the lower the chance of new-borns to survive.