Ali M A, Latif T, Islam M N, Hossain M A, Fakir H J, Haque S A, Khan R H, Chowdhury B
Dr Md Ayub Ali, Associate Professor, Department of Neonatology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh.
Mymensingh Med J. 2016 Oct;25(4):647-651.
Low birth weight (LBW) is the major neonatal health problem in Bangladesh like other developing countries with limited resource. But only a few studies had done about status of LBW at hospital setting in this country. The objective of the study that to evaluate the status and immediate outcome of the LBW This cross sectional retrospective study was done in neonatal ward of Mymensingh medical college hospital. In this 1000 bedded tertiary care level teaching hospital only 40 cots and 10 open incubators are sanctioned but daily average admission in neonatal ward more than 30. On an average about 100 patients are remaining in the ward. Three or four patients are nursed in each cot. It covers the vast catchment's area of Bangladesh having more than two cores of population. With limited resources and manpower, this neonatal ward has to bear the burden of 100 neonates and daily admission of 30 neonates. Study period was one year (October 2013 to September 2014). Total admitted neonates were 8359. All admitted neonates were considered as study population and all LBW babies were considered as sample. Among total population 41% (3423) were LBW. Among total LBW babies maximum (80.7%) had birth weight 1500-2499gm followed by Very Low birth weight (VLBW) 1000 - 1499gm 14.7%, Extreme Low birth weight (ELBW) 1000-750gm 1.6% and Incredible low birth weight <750gm 1.7%. Term LBW (IUGR) babies were 52% and preterm LBW were 48%. Death rate among LBW babies group were higher (18.5%) than death rate (15.8%) among all admitted neonate. By comparison of mortality rate among different subgroup of LBW shows highest mortality (65.5%) was in incredible low birth weight babies group followed by ELBW group (58.8%) and among VLBW group 26.4% and lowest mortality (15.3%) was among birth weight 1500-2499gm group babies. Death rate was inversely related to birth weight. Death rate among preterm LBW babies (21.5%) was higher than Term LBW (IUGR) babies (15.7%). So, death rate was also inversely related to the maturity. Death rate among LBW babies is still higher in our institute than other developed institute of home and abroad. Death rate specially higher among incredible birth weight group and ELBW group in our institute. Further improvement in neonatal care is needed to decrease the mortality among LBW babies.
与其他资源有限的发展中国家一样,低出生体重是孟加拉国主要的新生儿健康问题。但该国关于医院环境下低出生体重状况的研究较少。本研究的目的是评估低出生体重的状况及其近期结局。这项横断面回顾性研究在迈门辛医学院医院的新生儿病房进行。在这家拥有1000张床位的三级护理教学医院,仅批准了40个婴儿床和10个开放式暖箱,但新生儿病房的日均入院人数超过30人。平均而言,病房里有大约100名患者。每个婴儿床护理三四个患者。它覆盖了孟加拉国人口超过两千万的广大地区。由于资源和人力有限,这个新生儿病房不得不承担100名新生儿的护理负担以及每天30名新生儿的入院量。研究期为一年(2013年10月至2014年9月)。总入院新生儿为8359名。所有入院新生儿被视为研究总体,所有低出生体重儿被视为样本。在总体中,41%(3423名)为低出生体重儿。在所有低出生体重儿中,出生体重在1500 - 2499克的最多(80.7%),其次是极低出生体重儿(1000 - 1499克)占14.7%,超低出生体重儿(1000 - 750克)占1.6%,极超低出生体重儿(<750克)占1.7%。足月低出生体重儿(宫内生长受限)占52%,早产低出生体重儿占48%。低出生体重儿组的死亡率(18.5%)高于所有入院新生儿的死亡率(15.8%)。通过比较不同低出生体重亚组的死亡率,显示极超低出生体重儿组死亡率最高(65.5%),其次是超低出生体重儿组(58.8%),极低出生体重儿组为26.4%,出生体重在1500 - 2499克组的死亡率最低(15.3%)。死亡率与出生体重呈负相关。早产低出生体重儿的死亡率(21.5%)高于足月低出生体重儿(宫内生长受限)(15.7%)。所以,死亡率也与成熟度呈负相关。在我们研究所,低出生体重儿的死亡率仍高于国内外其他发达机构。在我们研究所,极超低出生体重组和超低出生体重组的死亡率尤其高。需要进一步改善新生儿护理以降低低出生体重儿的死亡率。