Pre-discharge neonatal morbidity and mortality in extremely preterm babies managed at Sri Jayewardenepura Teaching Hospital

Abstract

Introduction: Global rate of preterm deliveries ranges from 5% to 18%. Out of them, babies with extreme prematurity pose a challenge to neonatologists due to associated high mortality and morbidity. Survival rate of extremely preterm babies is known to be 30-50% worldwide. Up to now Sri Lankan data regarding morbidity and mortality of extremely preterm babies are not available. Objectives: To evaluate pre-discharge neonatal mortality and morbidity in extremely preterm babies managed at Sri Jayewardenepura Teaching Hospital. Method: A retrospective cohort study was conducted from January 2010 to May 2017. Hospital records were utilised to obtain demographic data and details regarding morbidity and mortality. Results were collected to data collection sheet. Data analysis was done using SPSS software. Results: There were 144 extremely preterm babies during the study period. Of them, 106 (73.6%) and 38 (26.3%) had extremely low birth weight and very low birth weight respectively. Ninety nine (68.8%) babies survived while 45 (31.3%) babies died. Of the deaths, 77.3% had occurred within the first two weeks of life. Commonest complications included surfactant deficient lung disease, sepsis, patent ductus arteriosus and hypotension. Average duration of hospital stay was 45 days for the survivors. Conclusions: Overall survival of extremely preterm babies born at Sri Jayewardenepura Teaching Hospital is 68.8%. Better survival is observed with advancing gestational age and higher birthweight. Commonest complications included SDLD followed by sepsis and PDA.