OBJECTIVE

To determine levels of mortality and risk factors for mortality in infants born with birth weights below 1,800 gms.

DESIGN

Prospective descriptive study.

SETTING

Harare Central Hospital in Zimbabwe.

SUBJECTS

All infants born and admitted to Harare Hospital Neonatal Unit between January and May 2000, with birth weight between 500 gms and 1,800 gms.

STUDY FACTORS

Mothers' age, parity, booking status, mode of delivery, infants' sex, birth weight, use of intensive care, outcome in hospital, age at death and age at discharge from hospital.

RESULTS

Four hundred and ninety infants were studied. In hospital, the fatality rate was 39.4%. Only 49.4% of mothers had received antenatal care. The median birth weight of those who died was 1,077 gms (Q1 = 500, Q3 = 1,357) while that of the discharged infants was 1,530 gms (Q1 = 850, Q3 = 1690). Risk factors for mortality were birth weight less than 1,500 gms compared to 1,500 gms or more. Odds Ratio (OR) 7.53 (95% CI = 4.66 to 12.23), breech delivery compared to vaginal delivery, OR 2.40 (95% CI = 1.28 to 4.52) and lack of antenatal care OR 1.59 (95% CI = 1.08 to 2.33). Parity, sex of infant and receiving intensive neonatal care were not significantly associated with mortality.

CONCLUSION

Strategies to reduce mortality in these infants should include better access to early, high quality obstetric care and avoidance of breech delivery in preterm infants. Identification of avoidable factors leading to preterm delivery is critical.