Outcome of Preterm Admissions at the Neonatal Unit of a Tertiary Care Military Hospital of Bangladesh

Introduction: Preterm deliveries contribute to major morbidity and mortality in developing countries. They are a leading cause of admission in neonatal care units. It is a major hindrance to the attainment of the Sustainable Development Goal (SDG)-3 targets given its high contribution to neonatal mortality. Early detection of its risk factors and advances in the management have ensured better survival of preterm births. This study was conducted to determine the prevalence, underlying causes, morbidity patterns and outcome of preterm admissions to a neonatal intensive care unit (NICU) of a tertiary care center in Combined Military Hospital (CMH) Sylhet. Material and Methods: A descriptive study was conducted in CMH Sylhet from July 2018 to June 2020. All live preterm babies delivered at CMH Sylhet during the study period were included. Information obtained included gestational age at birth, gender, cause for preterm birth, problems during admission and outcome. Results: During this period, a total of 662 neonates were admitted out of which 107 (16.2%) were preterm with gestational ages ranging from 27 completed weeks to less than 37 completed weeks with a mean gestational age 33.2 weeks (± 2.7 weeks) and birth weights from 800 - 2600 gm with a mean of 2100 gm (± 700 gm). There were 52 males and 55 females (M: F 0.95). One hundred and thirty three (20.1%) were delivered by normal vaginal delivery while 529 (79.9%) were delivered by Caesarean section. The duration of hospital stay ranged from 1 - 45 days, with a mean duration of 15 days (± 9.2 days). The commonest reason for prematurity was premature rupture of membrane (PROM) (39.3%) followed by gestational diabetes mellitus (GDM) (35.5%), hypertensive disorders in pregnancy (30.8%), multiple pregnancy (29.9%) and inadequate ante natal care (ANC) (20.6%). The commonest morbidity in the patients in the present study was neonatal jaundice (90.7%) followed by respiratory problems (78.5%), sepsis (17.8%) and congenital heart disease (CHD) (15.9%). Case fatality rate for patients with respiratory distress syndrome (7.7%) and sepsis (5.3%) were common. Overall survival rate was 91.6% and was significantly (p <0.001) higher in the moderate to late preterm category compared to the very preterm and extremely preterm births. Conclusion: PROM, GDM, hypertensive disorders in pregnancy, multiple pregnancy and inadequate ante natal care were significantly associated with preterm birth. Neonatal jaundice, respiratory problems, sepsis and CHD were common morbidities observed. Case fatality rate was significant in neonates with respiratory distress syndrome and sepsis and overall survival rate was 91.6%. So, at-risk mothers should receive intensified antenatal care to mitigate preterm birth. J Bangladesh Coll Phys Surg 2022; 40: 39-44

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Preterm Births and Associated Factors among Mothers Who Gave Birth in Axum and Adwa Town Public Hospitals, Tigrai, Northern Ethiopia, 2018.

10.21203/rs.2.13355/v1 ◽

2019 ◽

Author(s):

Gebrekiros Aregawi Gebremeskel ◽

Nega Assefa kassa ◽

Frehiwot mesfin Mengistu ◽

Fisseha Tekulu Welay ◽

Tesfay Adhena Hailu ◽

...

Keyword(s):

Preterm Birth ◽

Chronic Illness ◽

Associated Factors ◽

Multiple Pregnancy ◽

Preterm Births ◽

Public Hospitals ◽

Northern Ethiopia ◽

Premature Rupture ◽

Malaria During Pregnancy ◽

Inter Pregnancy Interval

Abstract Objective: The objective of this study was to determine the prevalence and associated factors of preterm births among mothers who gave birth in Axum and Adwa public hospitals, Tigray, North Ethiopia, 2018. Result: This study showed that 13.3% from the total 472 mothers gave a preterm birth. Being a rural resident (AOR=2.13,95% CI:(1.07,4.22), short inter pregnancy interval (AOR= 5.4, 95% CI: (1.32, 22.05), previous preterm birth(AOR= 3.74, 95% CI: (1.03, 16.34), Premature rupture of membrane(AOR=4.14, 95% CI: (1.92, 8.89), induced onset of labor(AOR=2.49, 95% CI: (1.06, 5.85) multiple pregnancy(AOR= 5.69, 95% CI: (2.27, 14.28), malaria during pregnancy (AOR= 4.71, 95% CI: (1.98, 11.23), Presence of chronic illness (AOR= 4.55, 95% CI: (1.83, 11.26) were significantly associated with preterm birth.

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Mortality profile of neonatal deaths and deaths due to neonatal sepsis in a tertiary care center in southern India: a retrospective study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20182569 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1583 ◽

Cited By ~ 1

Author(s):

N. Muthukumaran

Keyword(s):

Neonatal Sepsis ◽

Congenital Malformations ◽

Case Fatality Rate ◽

Distress Syndrome ◽

Tertiary Care ◽

Case Fatality ◽

Meconium Aspiration Syndrome ◽

Coagulase Negative Staphylococcus ◽

Fatality Rate ◽

Neonatal Deaths

Background: The Neonatal mortality rate is an important indicator for newborn care and directly reflects prenatal, intranatal, and postnatal care. Objective: Primary objective was to analyse the neonatal mortality profile, incidence of neonatal sepsis among neonatal deaths and the pattern of antimicrobial resistance.Methods: This was a retrospective descriptive study done in a tertiary care regional center. All neonatal deaths from January 2017 to December 2017 were reviewed and primary causes of deaths, incidence of sepsis among neonatal deaths and pattern of antimicrobial resistance were analyzed.Results: Common causes of neonatal deaths were respiratory distress syndrome (27.4%), asphyxia (23.3%), sepsis (20.1%), congenital malformations, extreme preterm, meconium aspiration syndrome. Case fatality rate was high in extreme preterm neonates (96.8%), followed by respiratory distress syndrome (35.9%), asphyxia (33%), meconium aspiration syndrome (29.4%), congenital malformations (28.8%), and sepsis (22.6%). In present study incidence of neonatal sepsis among total neonatal deaths was about 20.1%. Coagulase negative staphylococcus(CONS) (38.6%) and Klebsiella pneumoniae (32.7%) were the predominant organisms isolated. Highest case fatality rate was associated with Pseudomonas sepsis (80%), K. pneumoniae sepsis (64.8%), followed by Escherichia coli sepsis (57%) and non fermenting Gram negative bacilli (55.6%).Conclusions: Sepsis still remains one of the leading cause of death in developing countries. Coagulase negative staphylococcus (CONS) and Klebsiella pneumoniae were the most common organism. 15 % enterococci and 9.7 % of CONS were resistant to vancomycin. 24 % of K. pneumoniae and 16.6% non fermenting Gram negative bacilli were resistant to amikacin. Multidrug resistance is an emerging problem.

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Preterm Birth: A Prominent Risk Factor for Low Apgar Scores

BioMed Research International ◽

10.1155/2015/978079 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Maria Svenvik ◽

Lars Brudin ◽

Marie Blomberg

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Preterm Birth ◽

Tertiary Care ◽

Multiple Pregnancy ◽

Apgar Scores ◽

Significant Difference ◽

Gestational Week ◽

Using Data ◽

Predictive Risk

Objective.To determine predictive risk factors for Apgar scores < 7 at 5 minutes at two hospitals providing tertiary care and secondary care, respectively.Methods.A retrospective registry cohort study of 21126 births (2006–2010) using data from digital medical records. Risk factors were analyzed by logistic regression analyses.Results. AS5min⁡<7was multivariately associated with the following: preterm birth; gestational week 32 + 0–36 + 6,OR=3.9(95% CI 2.9–5.3); week 28 + 0–31 + 6,OR=8(5–12); week < 28 + 0,OR=15(8–29); postterm birth,OR=2.0(1.7–2.3); multiple pregnancy,OR=3.53(1.79–6.96); previous cesarean section,OR=3.67(2.31–5.81); BMI 25–29,OR=1.30(1.09–1.55);BMI≥30 OR=1.70(1.20–2.41); nonnormal CTG at admission,OR=1.98(1.48–2.66). ≥1-para was associated with a decreased risk forAS5min⁡<7,OR=0.34(0.25–0.47). In the univariate logistic regression analysisAS5min⁡<7was associated with tertiary level care,OR=1.48(1.17–1.87); however, in the multivariate analysis there was no significant difference.Conclusion.A number of partially preventable risk factors were identified, preterm birth being the most evident. Further, no significant difference between the two hospital levels regarding the risk for low Apgar scores was detected.

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Preterm Births and Associated Factors among Mothers Who Gave Birth in Axum and Adwa Town Public Hospitals, Northern Ethiopia, 2018.

10.21203/rs.2.13355/v2 ◽

2019 ◽

Author(s):

Gebrekiros Aregawi Gebremeskel ◽

Nega Assefa kassa ◽

Frehiwot mesfin Mengistu ◽

Fisseha Tekulu Welay ◽

Tesfay Adhena Hailu ◽

...

Keyword(s):

Preterm Birth ◽

Chronic Illness ◽

Associated Factors ◽

Multiple Pregnancy ◽

Preterm Births ◽

Public Hospitals ◽

Northern Ethiopia ◽

Premature Rupture ◽

Malaria During Pregnancy ◽

Inter Pregnancy Interval

Abstract Objective: The objective of this study was to determine the prevalence and associated factors of preterm births among mothers who gave birth in Axum and Adwa public hospitals, North Ethiopia, 2018. Result: This study showed that 13.3% from the total 472 mothers gave a preterm birth. Being a rural resident (AOR=2.13,95% CI:(1.07,4.22), short inter pregnancy interval (AOR= 5.4, 95% CI: (1.32, 22.05), previous preterm birth(AOR= 3.74, 95% CI: (1.03, 16.34), Premature rupture of membrane(AOR=4.14, 95% CI: (1.92, 8.89), induced onset of labor(AOR=2.49, 95% CI: (1.06, 5.85) multiple pregnancy(AOR= 5.69, 95% CI: (2.27, 14.28), malaria during pregnancy (AOR= 4.71, 95% CI: (1.98, 11.23), Presence of chronic illness (AOR= 4.55, 95% CI: (1.83, 11.26) were significantly associated with preterm birth.

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IMMEDIATE OUTCOME OF PRETERM BABIES BORN IN A TERTIARY RURAL CARE CENTER

10.36106/gjra/2309767 ◽

2021 ◽

pp. 22-27

Author(s):

Rohan Yadav ◽

P. Sunil Kumar ◽

Mahendrappa K.B. ◽

G.M. Kumar ◽

Channabasavanna N

Keyword(s):

Preterm Birth ◽

Observational Study ◽

Early Recognition ◽

Care Center ◽

Tertiary Care ◽

Ventilatory Support ◽

Birth Asphyxia ◽

Preterm Births ◽

Female Ratio ◽

Preterm Babies

Introduction. In neonatology preterm birth is one of the major issues as it leads to perinatal mortality and serious neonatal morbidity. Complications related to preterm birth are the leading cause of under ve 2 children death responsible for approximately 1 million death worldwide in 2015. Though Preterm births is a worldwide problem, >60% of preterm happen in South Asian countries and Africa. Since few studies have been done in rural setup this observational study of immediate outcome of preterm babies born in a rural tertiary care center has been taken up. Material and methods. This prospective observational study was done in Adichunchanagiri Institute of Medical sciences, st st Mandya from 1 August 2019 – 31 July 2020. Study sample comprised of 100 preterm babies who were born in the study period. Data was collected on a preformed Performa, it was complied and entered in a MS excel sheet. Results. Majority of preterm births in this study were in 32-36weeks which accounted for 86% of the babies. In this study male to female ratio was 0.81:1. More babies were AGA (71%) then SGA (29%). Common fetal morbidities were RDS (28%), NNH (28%), Birth asphyxia (17%), sepsis (13%). CPAP was required in 19 babies and majority of them had RDS. Ventilatory support was required in 7 babies. Mean duration of total stay was 10.64±7.65 days. In our study preterm mortality was 3% which was caused by RDS. Conclusion. Early recognition of preterm morbidities and prompt treatment can reduce preterm mortality.

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A study of etiology and outcome of preterm birth at a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174429 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4488

Author(s):

Shaveta Garg ◽

Tajinder Kaur ◽

Ajayveer Singh Saran ◽

Monu Yadav

Keyword(s):

Preterm Birth ◽

Tertiary Care ◽

Preterm Births ◽

Active Phase ◽

Care Hospital ◽

Tertiary Care Centre ◽

Mortality And Morbidity ◽

High Incidence ◽

History Of ◽

Tract Infections

Background: Preterm births are still the leading cause of perinatal mortality and morbidity. It is a major challenge in the obstetrical health care.Methods: This study was conducted over a period of eight months from September 2016 till April 2017 at a tertiary care hospital. All patients who delivered a live baby before 37 weeks of gestation were included in the study.Results: Present study was conducted on 100 eligible women out of which 7 delivered before 30 weeks but majority of them (55%) delivered after 34 weeks of gestation. In our study, most of the patients (66%) presented in active phase of labor which resulted in preterm birth of baby. The most common risk factor of preterm labor was genitourinary tract infections (34%) followed by Preterm Premature rupture of membranes (22%). Past obstetric history of preterm delivery and abortions also had a significant impact on the present pregnancy outcome.Conclusions: Preterm labour and birth still have a high incidence causing significant neonatal mortality and morbidity as well as economic burden on family and hospital. The causes of preterm birth are multifactorial and modifiable. This incidence can be reduced by early identification of established risk factors, as revisited and reemphasized in our study, with the help of universal and proper antenatal care.

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Preterm births and associated factors among mothers who gave birth in Axum and Adwa Town public hospitals, Northern Ethiopia, 2018

BMC Research Notes ◽

10.1186/s13104-019-4650-0 ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Gebrekiros Aregawi ◽

Nega Assefa ◽

Firehiwot Mesfin ◽

Fissaha Tekulu ◽

Tesfay Adhena ◽

...

Keyword(s):

Preterm Birth ◽

Chronic Illness ◽

Associated Factors ◽

Multiple Pregnancy ◽

Preterm Births ◽

Public Hospitals ◽

Northern Ethiopia ◽

Premature Rupture ◽

Malaria During Pregnancy ◽

Inter Pregnancy Interval

Abstract Objective The objective of this study was to determine the prevalence and associated factors of preterm births among mothers who gave birth in Axum and Adwa public hospitals, Tigray, North Ethiopia, 2018. Result This study showed that 13.3% from the total 472 mothers gave a preterm birth. Being a rural resident (AOR = 2.13, 95% CI (1.07,4.22), short inter pregnancy interval (AOR = 5.4, 95% CI (1.32, 22.05), previous preterm birth (AOR = 3.74, 95% CI (1.03, 16.34), Premature rupture of membrane (AOR = 4.14, 95% CI (1.92, 8.89), induced onset of labor (AOR = 2.49, 95% CI (1.06, 5.85) multiple pregnancy (AOR = 5.69, 95% CI (2.27, 14.28), malaria during pregnancy (AOR = 4.71, 95% CI (1.98, 11.23), Presence of chronic illness (AOR = 4.55, 95% CI (1.83, 11.26) were significantly associated with preterm birth.

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Prevalence and Outcome of Preterm Births in the National Referral Hospital in Bhutan: An Observational Study

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmz046 ◽

2019 ◽

Vol 66 (2) ◽

pp. 163-170

Author(s):

Dinesh Pradhan ◽

Yoriko Nishizawa ◽

Hari P Chhetri

Keyword(s):

Preterm Birth ◽

Birth Rate ◽

Tertiary Care ◽

Preterm Births ◽

Referral Hospital ◽

Preterm Neonates ◽

Care Hospital ◽

Increased Risk ◽

Preterm Birth Rate ◽

National Referral Hospital

Abstract Introduction Preterm birth-related complications are the leading cause of under-5 mortality globally. Bhutan does not have a reliable preterm birth rate or data regarding outcome of preterm babies. Aim To determine the preterm birth rate at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu, Bhutan, and assess their outcomes. Methods All live preterm births at JDWNRH from 1 January 2017 to 31 December 2017 were followed from birth till hospital discharge. Maternal demographic data, pregnancy details and delivery details were collected. Morbidity and mortality information as well as discharge outcome were collected on babies admitted to neonatal intensive care unit (NICU). Results Preterm birth rate among live births was 6.4%. Most mothers were younger than 30 years, housewives and had secondary education. Pregnancy registration rate and adequacy of antenatal visits were high. Most preterm births were singleton and the predominant mode of delivery was cesarean section. More than half of the births were initiated spontaneously, and the male:female ratio was 1.2:1. Most babies were late preterm and low birth weight. Half of them required NICU admission. Overall mortality rate was 11% and 21.6% for admitted preterm neonates. Preterm small-for-gestational-age neonates, and those born after provider-initiated preterm birth had significantly increased risk of mortality. Most preterm neonates were discharged without complications. The rate of extrauterine growth restriction was high. Conclusion This is the first study on the prevalence of preterm births and their outcomes in the largest tertiary-care hospital in Bhutan.

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Maternal and foetal outcome in preterm births in a rural tertiary care centre: a retrospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20215073 ◽

2021 ◽

Vol 11 (1) ◽

pp. 50

Author(s):

Deeksha Rao M. ◽

Vasantha Kumar S.

Keyword(s):

Retrospective Study ◽

Preterm Birth ◽

Tertiary Care ◽

Preterm Births ◽

Morbidity And Mortality ◽

Care Hospital ◽

Tertiary Care Centre ◽

Mortality And Morbidity ◽

Medical Disorders ◽

Nicu Admission

Background: Preterm birth (PTB) is one of the main causes of perinatal mortality and morbidity. It can also result in long term health consequences for both mother and the newborn. The objective was to assess maternal and fetal morbidity and mortality in PTBs.Methods: A retrospective study was done in the department of obstetrics and gynecology in a tertiary care hospital during January 2020 and June 2020. Ninety-three women with records of preterm births were analyzed for maternal and fetal outcomes. coGuide statistical software was used for data analysis.Results: 48.39% of the women were between 20 to 24 years of age. The majority (50.54%) were primigravida. The main causes for PTB among the study participants were medical disorders (39.78%), PPROM (29.03%), spontaneous labor without any underlying cause (18.28%). 51.61% had a vaginal delivery, 88.17% had a live birth. The majority of 52 (55.91%) neonates had birth weights between 1.51 to 2.5 kg. Fifty-nine neonates (63.44%) needed NICU admission. The reason for NICU admission in majority 25 (26.88%) was respiratory distress.Conclusions: Timely, early diagnosis and treatment of medical disorders among antenatal women can aid in reducing the occurrence of preterm births and their associated morbidity and mortality. Medical disorders and premature preterm rupture of membrane remain the main causes of preterm birth.

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Spectrum of Respiratory Distress in Newborn: A Study From a Tertiary Care Military Hospital

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v39i1.50450 ◽

2020 ◽

Vol 39 (1) ◽

pp. 4-8

Author(s):

Biplob Kumar Raha ◽

Md Julfikkar Alam ◽

Mohammad Abdul Quddus Bhuiyan

Keyword(s):

Mechanical Ventilation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Neonatal Intensive Care ◽

Distress Syndrome ◽

Perinatal Asphyxia ◽

Tertiary Care ◽

Military Hospital ◽

Male Predominance ◽

High Flow Oxygen

Introduction: Respiratory distress (RD) is a common problem in neonatal period. It is an important cause of neonatal mortality. There are many causes of respiratory distress, among them, transient tachypnea of newborn (TTN), respiratory distress syndrome (RDS) and perinatal asphyxia are commonest causes. Timely and appropriate therapy is essential to prevent ongoing injury and improve outcome. The aim of this study was to determine the prevalence and to identify the causes of respiratory distress in neonatal intensive care unit (NICU) in Combined Military hospital (CMH) Sylhet and to observe the hospital outcome of these babies. Material and Methods: A descriptive type of crosssectional study was conducted in CMH Sylhet over a period of one year from April 2018 to March 2019. All live newborns delivered at CMH Sylhet during the study period were included and observed for development of respiratory distress. Results: All newborns (n=287), delivered at this hospital over the period of 12 months, were observed for respiratory distress. The overall prevalence of respiratory distress was 19.2 %. Prevalence was 10.8 % in full term, 7.3 % in preterm and 1.1% in post term. There was male predominance (54.5%) and two third (71.1%) were born by cesarean section. Transient tachypnea of newborn was found to be the commonest 47.3% cause of respiratory distress followed by respiratory distress syndrome 29.1%, perinatal asphyxia (10.9%), congenital pneumonia 3.6%, congenital heart disease 3.6%, septicaemia 3.6% and meconium aspiration syndrome (MAS) 1.9%. All babies required high flow oxygen initially, subsequently Bubble CPAP and mechanical ventilation was required in 8 (14.5%) and 1(1.8%) cases respectively. Mortality was 1.8% in neonates with respiratory distress syndrome with pneumothorax with septicaemia requiring mechanical ventilation. Conclusion: In this series, RDS in newborn majority of cases were due to TTN followed by respiratory distress syndrome and perinatal asphyxia. Mortality was mainly related to pneumothorax with septicaemia, RDS was more common in births related to caesarian section. J Bangladesh Coll Phys Surg 2021; 39(1): 4-8

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