Predictors of mortality of extremely low birthweight babies in a tertiary care centre of a developing country.

INTRODUCTION

Perinatal care has changed dramatically over last decade contributing to improved survival of extremely low birthweight (ELBW) babies.

OBJECTIVE

We conducted the present study with the objective to identify immediate obstetric causes of preterm delivery; analyse the maternal risk factors and to evaluate the morbidity and mortality of ELBW babies delivered in our hospital. The results were compared with those of 10 years ago from the same hospital to determine whether there has been any significant change in the predictors of mortality

METHODS

A retrospective analysis of case records of 283 ELBW babies delivered in our hospital over a period of 24 months from 1 April 2010 to 31 March 2012 was conducted.

RESULTS

The total neonatal mortality rate was 38.7%. 85 babies (30%) were small for gestational age. Mean gestational age and mean birth weight was 28.5 weeks and 883.4 g, respectively. Using multivariate logistic regression analysis, significant risk factors for neonatal mortality in mothers were anaemia (p=0.00001, OR 3.13, CI 1.756 to 5.56), inadequate antenatal care (p=0.00001, OR 4.74, CI 2.59 to 8.69) premature rupture of membrane with antenatal antibiotic usage (p=0.003, OR 3.375, CI 1.512 to 7.53. Risk factors for mortality in babies were male sex (p=0.08, OR 3.48 CI 1.4 to 8.8), lower birth weight (p=0.000005), lower gestational age (p=0.00001) use of respiratory support in the form of continuous positive airway pressure (p=0.03), or mechanical ventilation (p=0.00001) and pulmonary or intraventricular haemorrhage (p=0.0001).

CONCLUSIONS

Babies with lower gestational age lower birth weight and those babies whose mothers had not received adequate antenatal care or antenatal steroids had worse prognosis.