Paediatrics, Walter Sisulu University, Mthatha, Eastern Cape, South Africa.
Children's Hospital, Neuropaediatrics, Developmental Neurology, Social Paediatrics, Eberhard Karls University Tübingen Faculty of Medicine, Tübingen, Baden-Württemberg, Germany.
BMJ Paediatr Open. 2021 Feb 17;5(1):e000918. doi: 10.1136/bmjpo-2020-000918. eCollection 2021.
Neonatal mortality is a major contributor worldwide to the number of deaths in children under 5 years of age. The primary objective of this study was to assess the overall mortality rate of babies with a birth weight equal or below 1500 g in a neonatal unit at a tertiary hospital in the Eastern Cape Province, South Africa. Furthermore, different maternal-related and infant-related factors for higher mortality were analysed.
This is a prospective cohort study which included infants admitted to the neonatal wards of the hospital within their first 24 hours of life and with a birth weight equal to or below 1500 g. Mothers who consented answered a questionnaire to identify factors for mortality.
173 very low birth weight (VLBW) infants were recruited in the neonatal department between November 2017 and December 2018, of whom 55 died (overall mortality rate 32.0%). Twenty-three of the 44 infants (53,5%) with a birth weight below 1000 g died during the admission. One hundred and sixty-one mothers completed the questionnaire and 45 of their babies died.Main factors associated with mortality were lower gestational age and lower birth weight. Need for ventilator support and sepsis were associated with higher mortality, as were maternal factors such as HIV infection and age below 20 years.
This prospective study looked at survival of VLBW babies in an underprivileged part of the Eastern Cape of South Africa. Compared with other public urban hospitals in the country, the survival rate remains unacceptably low. Further research is required to find the associated causes and appropriate ways to address these.
新生儿死亡率是全球导致 5 岁以下儿童死亡的主要原因之一。本研究的主要目的是评估南非东开普省一家三级医院新生儿病房中出生体重等于或低于 1500 克的婴儿的总体死亡率。此外，还分析了不同的与产妇和婴儿相关的导致高死亡率的因素。
这是一项前瞻性队列研究，纳入了在生命最初 24 小时内入住医院新生儿病房且出生体重等于或低于 1500 克的婴儿。同意的母亲回答了一份问卷，以确定导致死亡的因素。
2017 年 11 月至 2018 年 12 月期间，新生儿科共收治了 173 例极低出生体重（VLBW）婴儿，其中 55 例死亡（总死亡率为 32.0%）。44 名出生体重低于 1000 克的婴儿中，有 23 名（53.5%）在住院期间死亡。161 位母亲完成了问卷，其中 45 位婴儿死亡。与死亡率相关的主要因素是较低的胎龄和较低的出生体重。需要呼吸机支持和败血症与较高的死亡率相关，HIV 感染和年龄低于 20 岁等产妇因素也与死亡率相关。
本前瞻性研究观察了南非东开普省贫困地区极低出生体重婴儿的生存情况。与该国其他公立城市医院相比，存活率仍然低得不可接受。需要进一步研究以找出相关原因，并找到解决这些问题的适当方法。
