Chapters authored
Factors Associated with Survival to Discharge of Newborns in a Middle-Income Country
Clinical and mortality audit is an essential part of quality improvement in health care; information obtained in this process is used to develop targeted interventions to improve outcome. This study aimed to determine predictors of short-term survival in neonates. An existing neonatal database was reviewed. A total of 5018 neonates > 400 g admitted to a tertiary hospital (Johannesburg South Africa) between 1 January 2013 and 31 December 2015 were analysed. Mean birth weight was 2148 g (standard deviation [SD]: 972) and mean gestational age was 34.2 weeks (SD: 4.8). Overall survival was 85.6% (4294/5018). The most common causes of death were prematurity (46.2%), hypoxia (19.5%) and infection (17.2). The strongest predictors of survival were birth weight (OR 1.0; 95% confidence intervals (CI): 1.0–1.01) and gestational age (OR = 1.1, 95% CI: 1.05–1.17). Other predictors of survival included metabolic acidosis (OR = 0.14, 95% CI: 0.09–0.20), hyperglycemia (OR = 0.31, 95% CI: 0.23–0.41), mechanical ventilation (OR = 0.35, 95% CI: 0.28–0.46), major birth defect (OR = 0.12, 95% CI: 0.08–0.18), resuscitation at birth (OR = 0.39, 95% CI: 0.31–0.49) and Caesarean section (OR = 1.8, 95% CI: 1.44–2.25). In conclusion, resources need to be focused on improved care of VLBW infants.
Part of the book: Epidemiology of Communicable and Non-Communicable Diseases