Neurodevelopmental outcomes of preterm babies during infancy in Eastern Uganda: a prospective cohort study

Background: Thrombocytopenia as a side effect of phototherapy has not been mentioned in the standard literature but was described briefly as isolated case reports after the phototherapy came in vogue in 1958. The purpose of this study was to find the incidence of thrombocytopenia in neonates with uncomplicated indirect hyperbilirubinemia receiving phototherapy in a referral hospital.Methods: This was a prospective cohort study conducted in a referral hospital over a period of 18 months from June 1, 2013 to November 1, 2014.Results: A total of 103 babies were enrolled. The overall incidence of post-phototherapy thrombocytopenia was 45.6% while mild, moderate and severe thrombocytopenia was present in 66%, 21.3% and 12.8% of babies respectively. The lowest platelet count observed was 31,000/mm3 but none of the neonates showed bleeding manifestations. The incidence of thrombocytopenia following phototherapy was significantly higher in preterm babies, infants who received double surface phototherapy, babies who received phototherapy for >72 hours and in babies who received phototherapy on day 2 or 3 of life.Conclusions: Neonates requiring phototherapy for hyperbilirubinemia are at risk of developing thrombocytopenia, hence the treatment should be initiated based on the standard guidelines. Unnecessary use and prolongation of phototherapy should be avoided considering the possible side effects. Platelet count should be monitored particularly in pre-term neonates receiving phototherapy. Neonates receiving double surface phototherapy and those requiring phototherapy for longer duration require more frequent platelet count monitoring.

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Mortality rate and associated factors among preterm babies born in Moshi, north – Tanzania: A prospective cohort study

10.21203/rs.2.12403/v1 ◽

2019 ◽

Author(s):

Rose Chengo ◽

Frida Mowo ◽

Clifford Silver Tarimo ◽

Michael Johnson Mahande

Keyword(s):

Cohort Study ◽

Mortality Rate ◽

Neonatal Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Associated Factors ◽

Neonatal Mortality Rate ◽

Live Births ◽

Extremely Preterm ◽

Preterm Babies

Abstract Introduction Globally, approximately 15 million babies are born before term each year. Of these, more than 1 million die within the first 28 days of their life. Understanding the mortality rate and its predictors during neonatal period among preterm babies is crucial to help designing interventions to avert the situation. This study aimed to determine the neonatal mortality rate and associated factors among preterm babies born in Moshi Municipality, Tanzania. Methodology A prospective cohort study was conducted in three hospitals in Moshi Municipality from December 2016 to May 2017. All live births at gestational age of <37 weeks and those of <24 hours were studied. Babies who died prior to gestation age assessment and those whose mother did not consent were excluded. Cox regression model was used to estimate maternal and fetal factors associated with neonatal mortality. A p-value of <0.05 was considered statistically significant. Results A total of 311 of preterm babies were recruited from 265 mothers and were followed for 28 days. The neonatal mortality rate was 6.5deaths per 1,000 preterm live births (95% CI: 4.83-8.61). It was higher among extremely preterm babies compared to very preterm ones (HR: 38.24; 95% CI: 16.62-87.96) versus (HR: 8.01; 95% CI: 3.96-16.20) respectively. Apgar score of <7 at 1st minute (HR: 14.03; 95% CI: 7.27-27.06), respiratory distress syndrome (HR: 8.14; 95% CI: 4.27-15.54) and antepartum hemorrhage (HR: 3.32; 95% CI: 1.49-7.39) were significantly associated with neonatal mortality. Conclusion Preterm birth complication is the major cause of neonatal death in the study setting. Interventions to address the identified risk factors may reduce neonatal mortality among preterm babies.

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