Prevalence and Outcome of Preterm Admissions at the Neonatal Unit of a Tertiary Health Centre in Southern Nigeria

Abstract

Background: Preterm babies have increased risk of morbidity and mortality which is inversely related to both gestational age and birth weight. Most preterm births result from maternal or foetal medical conditions. Objectives: To determine the prevalence and outcome of preterm admissions at the Special Care Baby Unit of the Niger Delta University Teaching Hospital, as well as their morbidity pattern and risk factors for preterm birth. Methodology: All preterm babies admitted from January 2010 to December 2012 were retrospectively studied. Information obtained included gestational age at birth, sex, risk factors for preterm birth, duration of admission, medical problems during admission and outcome. Results: Preterm admissions constituted 24.0% of the total admissions with a male to female ratio of 1.1:1. The commonest risk factor for preterm birth was preterm rupture of foetal membranes (46.4%) followed by lack of maternal antenatal care (35.5%) and multiple pregnancy (26.8%) respectively. The commonest medical conditions were respiratory problems in 95 (68.8%) followed by jaundice in 94 (68.1%) and sepsis in 54 (39.1%) of the patients. The case fatality rate was highest in the patients with necrotizing enterocolitis and seizures (66.7%) followed by respiratory problems (63.2%) and bleeding disorders (60.0%). The overall survival rate was 65.9%. The survival rate was significantly higher in the mild preterm category compared to the very preterm and extremely preterm for birth categories χ2 = 29.24, p value = 0.000. Conclusion: Preterms constituted a significant percentage of neonatal admissions at the Niger Delta University Teaching Hospital with the case fatality being highest among those with infections and respiratory problems. There is an urgent need for the establishment of a neonatal intensive care unit with facilities for thorough evaluation and management of preterm babies in order to improve survival rate of this vulnerable group of patients.