Risk factors for severe early neonatal morbidity among term neonates admitted at Muhimbili National Hospital, Tanzania: A nested case control study
Keywords:
Severe Early Neonatal Morbidity, Neonates, Fetal and Neonatal FactorsAbstract
Background: Earlyneonatal problems are most likely in the early term. The first-week accounts for 75% of the 4 million neonatal deaths worldwide. Mortality is greater for very sick neonates. More research is done on premature babies' risk of severe early-neonatal morbidity. Term neonates are healthier due to physiological maturity; their risk factors vary. A study of term neonates admitted at MNH Neonatal Care Unit within seven days of delivery identified significant morbidity risk factors.
Methods: All term neonates admitted within seven days of delivery from September to December 2014 were studied in a nested case-control study. We collected and followed up using the MAIN score checklist. Dead morbidity items during seven days of delivery separated severe from less severe-morbid babies. Neonatal unit case notes, RCH4 cards, delivery records, and mother interviews gave data. Univariate regressions calculated severe morbidity risks and clinical significance of risk factors using odds ratios and 95% CIs. A multivariate analysis identified independent risk factors for severe morbidity. P-values under 0.05 were significant. Ethical approval came from Muhimbili National Hospital and the MUHAS Senate Research and Publication Committee.
Results: Of 2104 babies admitted to MNH-NCU during the experiment, 1624 didn't meet the requirements. Out of 463 term newborns, 220 (47.5%) suffered substantial early neonatal morbidity. Term babies had 255.7/1000 early neonatal morbidity. UTI during pregnancy and low-term birth weight independently predicted severe early neonatal morbidity.
Conclusion: Many term infants without congenital abnormalities showed high early neonatal morbidity, requiring further study. Further studies should discover more risk factors.
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