Determinants and outcomes of low birth weight among newborns at a Tertiary Hospital in Zambia: A retrospective cohort study

Aim: This study aimed to assess determinants and outcomes of LBW among newborns at a tertiary hospital. Settings and Design: Retrospective cohort study at Women and Newborn Hospital in Lusaka Zambia. Subjects and Methods: We reviewed delivery case records and neonatal files between January 1, 2018, and September 30, 2019, for newborns admitted to the neonatal intensive care unit. Statistical Analysis Used: Logistic regression models were used to establish determinants of LBW and describe the outcomes. Results: Women living with human immunodeficiency virus infection were more likely to deliver LBW infants (adjusted odds ratio [AOR] = 1.46; 95% confidence interval [CI]: 1.16­1.86). Other maternal determinants of LBW were; increased parity (AOR = 1.22; 95% CI: 1.05­1.43), preeclampsia (AOR = 6.91; 95% CI: 1.48­32.36), and gestational age <37 weeks compared to 37 weeks or more (AOR = 24.83; 95% CI: 13.27­46.44). LBW neonates were at higher odds of early mortality (AOR = 2.16; 95% CI: 1.85­2.52), developing respiratory distress syndrome (AOR = 2.96; 95% CI: 2.53­3.47), and necrotizing enterocolitis (AOR = 1.66; 95% CI: 1.16­2.38) than neonates with a birth weight of 2500 g or more. Conclusions: These findings underscore the importance of effective maternal and neonatal interventions to reduce the risk of morbidity and mortality for neonates with LBW in Zambia and other similar settings.

Ferritin concentrations in low-birth babies in South-west Nigeria

In the absence of acute phase reaction, ferritin concentration has been used as a standard measurement of iron stores. Low birth weight babies are at risk of developing iron lack because ferritin concentration at birth is influenced by duration of gestation, maternal iron status and conditions altering maternal­foetal iron exchange. Aim: The aim of this study was to determine the ferritin concentrations of low birth weight babies in comparison with that of normal birth weight babies. Materials and methods: Fortyfour normal birth weight (NBW) babies and 40 low birth weight (LBW) babies were recruited for the study. About 1.0ml of venous blood was drawn aseptically from each subject into a micro EDTA tube, centrifuged at 5000rpm for 5 minutes, the plasma separated into cryotubes and stored at-20oC until ready for quantitative determination of ferritin concentrations using direct immunoenzymatic colorimetric method.Data obtained was analysed statistically using the Statistical Package for Social Sciences (SPSS,version 23, Chicago, IL, USA). Results: Gestational age correlated positively with ferritin concentrations in LBW neonates (p<0.05)while APGAR score correlatepositively with ferritin concentrations in normal birth weight babies (r=0.398; p<0.05). Thoug not statistically significant (p=0.214), median values for ferritin concentrations were 188.5µg/ dl and 373µg/dl for LBW and NBW neonates respectively. Conclusion: Gestational age correlated positively with ferritin concentrations in LBW neonates

Profil épidémiologique et facteurs de risque de faible poids de naissance à l'hôpital général de référence de Katwa au Nord-Est de la RD Congo / NA

Introduction : Le faible poids de naissance est responsable de 9.1 millions décès d'enfants chaque année dans le monde. Il est la principale cause de mortalité périnatale et infantile. L'objectif de ce travail était de déterminer le profil épidémiologique ainsi que les facteurs de risque de faible poids de naissance à l'Hôpital Général de Référence de Katwa, Nord-Est de la RD Congo. Méthodes : Notre étude était transversale du type cas-témoins non apparié ayant couvert une période allant du 1er janvier 2019 au 31 décembre 2020. Les données ont été tirées des dossiers d'hospitalisation. Le traitement des données a été réalisé par le logiciel EPI info 7. Résultats : La fréquence de faible poids de naissance était de 11,8%. La primiparité multipliait par 4,2 le risque de faible poids de naissance, la grossesse multiple par 2,1, sexe masculin du fœtus par 2,8, la prématurité par 5,5, la malnutrition maternelle par 1,4, le paludisme au cours de la grossesse par 1,5 et les troubles hypertensifs par 1,7. Conclusion. Le faible poids de naissance est fréquent dans nos milieux avec des facteurs de risque modifiables. Les praticiens doivent jouer sur eux pour minimiser son importance.

Introduction: Low birth weight is responsible for 9.1 million infant deaths each year worldwide. It is the leading cause of perinatal and infant mortality. The objective of this study was to determine the epidemiological profile and risk factors of low birth weight in the General Reference Hospital of Katwa, North-East of the DR Congo.. Methods: Our study was a cross-sectional, unpaired case-control study covering a period from January 1, 2019, to December 31, 2020. Data were obtained from hospitalization records. Data processing was performed by EPI info 7 software.. Results: he frequency of low birth weight was 11.8%. Primiparity multiplied the risk of low birth weight by 4.2, multiple pregnancy by 2.1, male sex of the fetus by 2.8, prematurity by 5.5, maternal malnutrition by 1.4, malaria during pregnancy by 1.5 and hypertensive disorders by 1.7. Conclusion: Low birth weight is common in our settings with modifiable risk factors. Practitioners must play on them to minimize its importance.

Immediate Seven Day Outcomes and Risk Factors of Low Birth Weight Neonates at Referral Hospitals in Mwanza City, Tanzania in October 2020

Every year more than 20 million neonates worldwide are born with low birth weight (LBW) per year. Ninety-five percent of LBW births occur in developing countries. The aim of this study was to determine Immediate Seven Day Outcomes and Risk Factors of Low Birth Weight Neonates at Referral Hospitals in Mwanza City. MATERIALS AND METHODS This was a hospital based observational prospective cohort study of neonates with LBW whom were followed up for seven days in the neonatal wards at referral hospitals in Mwanza city. Maternal social-demographic, newborns clinical data and vitality outcomes were collected. Categorical and continuous variables were summarized and presented in tables or bar charts. Any p-value of < 0.05, at 95% confidence interval was regarded as statistically significant. RESULTS Total of 200 neonates with median age of 0.8 days at baseline were enrolled. Amongst 148 (74 %) had prolonged hospitalization; due to sickness 88 (59%), and 60 (40%) due to poor weight gain. Whereas, the remaining 42 (21%) were discharged and 10 (5%) died within seven days. Prolonged hospitalization was associated with family income (p-value= <0.001) and place of delivery (p-value = <0.001). African Journal of Health Sciences Volume 34, Issue No.4, July- August 2021 452 Neonatal death was associated with family income (p-value =0.035) and birth weight (p-value = 0.019). Early discharge associated with gestational age at first antenatal visit, family income, mode of delivery, APGAR score at one minute, time interval between delivery and admission and timing of medication initiation. CONCLUSION LBW neonates are at high risk of death and prolonged hospitalization due to sickness or due to poor weight gain. Associated factors of these outcomes were family income, place of delivery, birth weight, gestation age during first antenatal visit, mode of delivered and low APGAR score.

Impact of maternal periodontitis on preterm birth and low biirth weight in babies: results of a scoping review

Background Periodontitis has been documented as public health concern but its association with preterm and low birth weight remains uncertain, thus the objective of this scoping review is to summarize the most recent published evidence related to the impact of periodontitis on preterm birth and low birth weight in order to improve public awareness and to inform policies for oral health during pregnancy. Methods Hinari, PubMed, and Google Scholar were searched to acquire the published literature. The retrieved studies included cross-sectional, case control studies and randomized controlled trials with available full text published in English from 2008 to 2019. Results After combining the key words, 333 articles were identified with only 133 eligible articles published from 2008 to 2019. After reviewing the available 50 full text articles, duplicates were removed and 15 studies fully met the inclusion criteria. There were 13 articles that supported the association between maternal periodontitis and preterm low birth weight while 2 found no evidence to support the association. Conclusion The results of this scoping review contribute to an increasing body of evidence to support the hypothesis that maternal periodontal disease may be a risk factor for preterm delivery and low birth weight.

Implementing the Family-Led Care model for preterm and low birth weight newborns in Malawi: experience of healthcare workers

Background: Every Preemie­SCALE developed and piloted the Family-Led Care model, an innovative, locally developed model of care for preterm and low birth weight babies receiving kangaroo mother care. Aim: The aim of this study was to describe healthcare workers' experience using Family-Led Care. Setting: This study was conducted in five health facilities and their catchment areas in Balaka district, Malawi. Methods: The mixed-methods design, with two data collection periods, included record reviews, observations and questionnaires for facility staff and qualitative interviews with health workers of these facilities and their catchment areas. The total convenience sample comprised 123 health professionals, support staff and non-professional community health workers. Results: Facility-based staff generally had positive perceptions of Family-Led Care (83%). Knowledge and application-of-knowledge scores were 69% and 52%, respectively. A major change between the first and the second data periods was improvement in client record-keeping. Documentation of newborn vital signs increased from 62% to 92%. Themes emerging from the qualitative interview analysis were the following: benefits of Family-Led Care; activities supporting the implementation of Family-Led Care; own care practices; and families' reaction to and experience of Family-Led Care. Conclusion: This article reports improved quality of care through better documentation and better follow-up of preterm and low birth weight babies receiving kangaroo mother care according to the Family-Led Care model. Overall, health workers were positive about their involvement, and they reported positive reactions from families. Lessons learned have been incorporated into a universal Family-Led Care package that is available for adaptation by other countries

Association between maternal serum homocysteine concentrations in early pregnancy and adverse pregnancy outcomes

There is still conflicting evidence on the extent to which maternal hyperhomocysteinemia is a risk factor for pregnancy complications. Aims: The study aimed to investigate the impact of elevated maternal homocysteine concentrations on adverse pregnancy outcomes among Nigerian women in Lagos. Materials and Methods: This was a prospective cohort study conducted at the Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria. Participants were enrolled during the first trimester of pregnancy following which relevant data were obtained by the interview. Fasting blood samples were collected for the measurement of maternal homocysteine concentration using the enzyme-linked immunosorbent assay method. Pregnancy outcomes and complications were obtained by abstracting the antenatal, delivery, and newborn medical records. Preterm births, low-birth weight (LBW), and antepartum fetal death were used as confirmatory outcome variables in the final analysis. Descriptive statistics for all data were computed using SPSS version 22.0. The associations between the variables were tested and multivariate analyses were used to study the effects of the major baseline characteristics on the pregnancy outcome. P < 0.05 was considered statistically significant. Results: Hyperhomocysteinemia was recorded in 41 (24.6%) patients. Women with a high homocysteine concentration and those with a normal homocysteine level did not differ significantly in terms of age (P = 0.684), level of education (P = 0.866), and parity (P = 0.647). Women with hyperhomocysteinemia had an approximately twelve-fold higher risk of preterm birth (P = 0.001) and a ten-fold higher risk of delivering a term neonate with LBW (P = 0.004), but had no risk of antepartum fetal death (P = 0.118) compared to women with a normal homocysteine concentration. Conclusions: The prevalence of hyperhomocysteinemia among mothers in Lagos was relatively low. The associations between hyperhomocysteinemia and adverse pregnancy outcomes could have implications in future for the prevention of these adverse outcomes

A retrospective study on the prevalence, severity and outcomes of intraventricular haemorrhage in infants with a low birth weight in a quarternary hospital in a low- to middle-income country

Background. Intraventricular haemorrhage (IVH) is a serious complication in infants with a low birth weight (LBW). Objective. To study the prevalence, severity and outcomes of IVH in LBW infants admitted to a neonatal intensive care unit (NICU). Methods. This was a retrospective cohort study of LBW infants admitted to the NICU at a quarternary hospital between January and December 2012. Neonates with recorded cranial ultrasound scans were included and followed up to between 18 and 24 months of age for neurological outcomes. Results. An overall IVH prevalence of 44.3% (95% confidence interval 40 - 50) was observed in the study population (N=210). The prevalence of IVH in infants with a very low birth weight (VLBW) was 67.0%. Multivariable logistic regression showed risk factors for IVH to be VLBW, extreme prematurity, exposure to HIV, outborn delivery and receipt of a blood transfusion. Moderate to severe IVH was more common in VLBW and extremely premature infants. Severe IVH was associated with high mortality. At follow-up, 18.8% of the subjects showed signs of neurodevelopmental delay, while 6.3% were diagnosed with epilepsy. The overall all-cause mortality rate was 15.7% at discharge. Mothers' antenatal clinic attendance and caesarean delivery were protective factors. Conclusion. Improved perinatal care for women in preterm labour, especially in rural areas in South Africa, could lead to better outcomes in infants. A screening schedule could contribute to timeous detection of brain injury in at-risk babies to facilitate appropriate medical management and detection of lesions associated with adverse long-term neurodevelopmental outcomes

Short-term outcomes of infants with an extremely low birth weight in a resource-limited neonatal intensive care unit, Grey's Hospital, KwaZulu-Natal

Background. Neonates with an extremely low birth weight (ELBW) constitute a small proportion of live births. However, there is limited information about the outcome of this specific group in developing countries, including South Africa (SA). Objective. To determine the outcome to discharge of ELBW neonates admitted to a resource-limited neonatal intensive care unit (NICU). Methods. A retrospective chart review was conducted of neonates admitted to the NICU at Grey's Hospital between 1 July 2011 and 30 June 2014. All neonates with a birth weight of <1 000 g and admitted to the unit within 24 hours of birth were included. Results. A total of 142 neonates met the inclusion criteria. Owing to lost files or incomplete data, 105 files were analysed in the final sample. The mean birth weight was 819.1 g and the mean gestational age was 27.5 weeks. The survival rate to discharge was 49.5%. Neonates born after 28 weeks of gestation and those with a birth weight of >900 g had better outcomes but without statistical significance. There were no statistically significant associations between outcome and any maternal variables. Nasal continuous positive airway pressure ventilation was associated with higher survival, but without statistical significance. Conclusion. The survival rate of ELBW neonates in this study is comparable to what has been reported in other developing countries, but higher than for other NICUs in SA with similar resource limitations. More studies are required to determine factors that may influence the survival rate of the ELBW neonates

The effects of maternal age and parity on the birth weight of newborns among mothers with singleton pregnancies and at term deliveries

Background: Birth weight is the most important factor determining the survival, growth and development of a newborn. Parity and maternal age have been shown to increase the risk of adverse neonatal outcomes, such as intra-uterine growth restriction (IUGR), low birth weight (LBW) and mortality. Objective of the study: The study was aimed at investigating the effects of maternal age and parity on the birth weight of newborns from singleton pregnancies and term deliveries. Materials and Methods: An institutional-based, retrospective, cross-sectional study design was employed at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia from April to July 2018. In total, 4,590 mothers with term delivery and singleton pregnancy from June 2015 to May 2017 were included in the study. Data on gestational age (GA), parity, history of ANC follow-up, source of referral and birth weight of the child was included. The collected data were analyzed using SPSS version 23 statistical package, and multiple logistic regression was carried out to determine the effect of maternal age and parity with respect to LBW. Results: Grand multiparous women (parity ≥5) have an adjusted odds ratio (AOR) of 3.89 with 95% confidence interval (CI = 2.19, 6.93) compared to multiparous women (p=2-4). Nulliparous women (p=0) have an AOR of 0.23 (95%CI = 0.19, 0.38) compared to multiparous women. Primiparous women (p=1) have an AOR of 0.22 (95% CI = 0.16, 0.30) compared to multiparous women. Women aged 40 and above have an AOR of 1.96 (95% CI = 1.22, 3.20) compared to women aged 30-34. The mean birth weight (MBW) of newborns was 3,075.41±569.58 grams (mean±SD). Conclusions: In this study, the risk of LBW was higher in grand multiparous women compared to multiparous women. Primiparous and nulliparous women have less risk of having an LBW baby compared to multiparous women. A maternal age of 40 and above were associated with a higher risk of delivering an LBW newborns compared to a maternal age of 30-34. Therefore, special attention should be given to deliveries at an advanced age and multiparous cases to reduce the incidence of LBW

Profil épidémiologique, diagnostique, thérapeutique et évolutif des nouveau-nés de faible poids de naissance transfusés au Centre Hospitalier Universitaire de Bouaké (Côte d'Ivoire)

Introduction : La transfusion sanguine est une pratique fréquente en néonatalogie. Aucune étude n'a porté sur cette thérapeutique salvatrice chez le Faible Poids de Naissance (FPN) au CHU de Bouaké. L'objectif de cette étude était de décrire le profil épidémiologique, diagnostique, thérapeutique et évolutif du FPN transfusés pour l'amélioration du pronostic et de la pratique professionnelle. Méthodes : Il s'agissait d'une étude rétrospective, descriptive et analytique réalisée de janvier 2016 à décembre 2017 dans l'unité de néonatalogie du CHU de Bouaké. Etaient inclus tout nouveau-né transfusé quel que soit l'âge gestationnel. Les variables étudiées étaient, l'âge, le sexe, les signes cliniques, les étiologies, la transfusion et l'évolution. Résultats : Sur 1186 nouveau-nés de faibles poids de naissances hospitalisés, 121 (65 garçons, 56 filles) ont été transfusés soit 10,2%. Le nouveau-né, référé dans 78,2%, était prématuré dans 85 cas et hypertrophie dans 36 cas. La prématurité (42,9%), la souffrance néonatale (14,7%) et la difficulté respiratoire (11,4%) étaient les principaux motifs d'admission. Le taux d'hémoglobine médian était de 12,1g/dL. L'infection néonatale (56%) et la prématurité (19%) étaient les principales étiologies. Le culot globulaire érythrocytaire était utilisé dans tous les cas. La transfusion était efficace dans 94,3%. La polytransfusion, 7 cas (5,7%), était motivée par la persistance des signes de décompensation anémique. L'évolution des nouveau-nés était marquée par la guérison 51,2%, le décès 43% et la sortie contre avis médical 5,8%. Conclusion : La transfusion est fréquente chez le FPN au CHU de Bouaké. L'amélioration du pronostic nécessite une bonne collaboration entre le gynécologue-obstétricien, le Centre de Transfusion Sanguine et le pédiatre

Relation entre santé parodontale chez la femme enceinte et faible poids du nouveau-né à la naissance à Dakar/Sénégal: étude cas-témoin

INTRODUCTION: Plusieurs facteurs de risques ont été incriminés dans la survenue du faible poids. Cependant Barnett et al trouvent que 25% des naissances de faible poids ou prématurés se produisent sans facteurs de risque connus. La relation entre la maladie parodontale et la grossesse et particulièrement le faible poids à la naissance a été évoquée par Offenbacher en 1996. L'objectif de ce travail est d'étudier la relation état parodontal chez la femme enceinte et la survenue du faible poids à la naissance du nouveau-né. MÉTHODE: L'étude était de type cas-témoin portant sur 397 patients dont 129 femmes enceintes donnant un bébé de faible poids (cas) versus 258 femmes enceintes donnant un bébé de poids normal (témoins). Les données collectées concernaient les caractéristiques sociodémographiques, les habitudes de vie, les données concernant le faible poids et celles parodontales : indice de plaque, indice de saignement papillaire perte d'attache clinique, profondeur de poche et le CPITN. Les données en analyse univariée étaient exprimées en proportions et moyennes puis des rapports de cotes avec leurs intervalles de confiance en analyse multivariée. RÉSULTATS: Les caractéristiques parodontales sont plus élevées chez les cas que chez les témoins. Il apparait que la parodontite était significativement associée au faible poids (P= 0,00013) ajustée sur l'âge de la mère, l'IMC et les autres paramètres parodontaux. L'âge de la mère et l'indice de plaque étaient marginalement associés au faible poids (P= 0,05 et 0,053) tandis que l'IMC, l'indice gingival et de saignement papillaire étaient aussi associés à la survenue du faible poids

Implementation of Kangaroo mother care by health workers in Nigeria

Background: Kangaroo Mother Care (KMC) has been proven to significantly improve growth, reduce mortality and morbidity in low birth weight infants. The impact of KMC in newborn care is expected to be greatest in Africa due to limitations in health care.Objective: The aim of this study was to determine the proportion of Nigerian health workers rendering paediatric care who practice KMC in their institution, and identify some challenges affecting the practice of KMC in Nigerian health institutions.Method: A cross sectional study of the participants at 45th annual scientific conference of the Paediatric Association of Nigeria was conducted.Result: A total of157 respondents 122(77.7%) doctors and 35 (22.3%) nurses were studied. 84 (53.5%) practiced KMC. The reasons for not practicing KMC were lack of policy reported by 43 (58.9%) and inadequate place for the mothers to stay 30(41%).The level of practice was significantly higher among respondents that worked in facilities that care for sick neonates (p = 0.049), have functional incubators (p = 0.014) and practice KMC (p < 0.001.Conclusion: Hospitals should have a written KMC policy and provide KMC wards in order to improve implementation of KMC practice in Nigeria

"""Raw"" Formula for Calculating Maintenance Fluid Volumes in Low Birth-Weight and Premature Babies"

BACKGROUND.Fluid management of low birth weight and preterm babies can be challenging; as the determination of maintenance fluid volumes have to be calculated to suit the demands of this delicate neonates in order to avoid fluid over-load or dehydration. It is on this background that this study to derive an easy to use formula for calculating maintenance fluid volumes in this category of babies was embarked upon; utilizing existing Tables.METHOD.One of the most developed Tables on this subject matter; the 'Paediatric Surgical Unit Guidelines; Sheffield Children's Hospital' was selected; re-ordered; subjected to analysis; factorization and simplification; in order to derive the formula. To validate its accuracy the Table was re-constructed using the derived Formula. The derived Table was then compared with the original table. The paired sample T- test; using variation in days and in weights; did not show any statistically significant (p0.05) difference between the two Tables RESULTS.From the Table the formula; 20{(R+A)-W}; ml kg~ 1 day~ 1 was derived. This translates to 20(R+A-W) ml kg~ 1 day 1or 0.8(R+A-W) ml kg ~ 1Hr~ K Where: R - Rehydration factor (ranging mostly from 3 to 5); A

Influence de l'age et de la parite de la mere sur le poids de naissance (Cas du Centre de Sante Shungu en RDC)

OBJECTIF:Cette etude avait pour objectif d'etablir la relation entre l'age; la parite de la mere d'une part et le poids a la naissance d'autre part MeTHODOLOGIE: Une etude transversale et descriptive; a ete menee sur un echantillon de 314 couples meres - enfants au Centre de Sante Shungu en RDC durant la periode allant du 1er Janvier 2010 au 31 Decembre 2011. Notre population d'etude concerne tous les cas des accouchements a terme durant la periode de l'etude. Les donnees ont ete recueillies a l'aide d'une grille a partir des registres de la maternite. Puis elles ont ete encodees; saisies; traitees et analysees a l'aide du logiciel SPSS (version 19). ReSULTATS L'analyse a revele que le poids moyen de naissance est significativement plus bas chez les primipares que chez les multipares et chez les meres de moins de 18 ans que chez celles de plus de 18 ans. Le risque d'accoucher d'un enfant de faible poids de naissance a ete 9 fois plus eleve chez les primipares que chez les multipares et 23 fois superieures chez les meres de moins de 18 ans que chez celles de plus de 18 ans. CONCLUSION : Le faible poids de la naissance est un probleme majeur de sante publique aussi bien dans les pays en voie de developpement que dans les pays developpes. La maitrise des facteurs maternels qui ont le plus d'influence sur le poids et sur lequel on peut agir tel que l'age; la parite; et l'etat nutritionnel est d'une necessite dans la lutte contre le faible poids de naissance

Utility of Kangaroo Mother Care in Preterm and Low Birthweight Infants

Preterm birth ( 37 completed weeks of gestation) is the largest direct cause of neonatal mortality; accounting for an estimated 27 of the 4-million neonatal deaths every year. Kangaroo mother care (KMC) is a type of care for preterm and premature infants whereby the infant is placed in an upright position against the parent's chest; with early skin-to-skin contact between the parent and infant. Mothers who practise KMC exhibit less maternal stress and fewer symptoms of depression; and have a better sense of the parenting role and more confidence in meeting their babies' needs than those who don't. Despite the apparent feasibility of KMC; currently; only a few preterm babies in low-income countries have access to this intervention. Knowledge of the effectiveness and safety of KMC in the community and home setting; and its effects on growth; is still incomplete. Only one study has examined KMC initiation at home. There is an immense need for the promotion of research to improve the delivery of existing cost-effective interventions in low-resource settings and to address key gaps in knowledge. KMC improves growth in low birthweight and preterm infants; and has a significant role to play in protecting them from hypothermia and sepsis; as well as promoting exclusive breastfeeding. KMC helps to reduce neonatal mortality; and inculcates confidence and a better sense of parenting in mothers with regard to their babies' needs

Low Birthweight Delivery : Prevalence and Associated Factors as Seen at a Tertiary Health Facility

Background: Low birth weight deliveries are major causes of a huge health burden on poor economies around the globe. It is even more worrisome in developing countries. Materials and Methods: The obstetric records of all low birth weight (LBW) deliveries were reviewed from 1 st June 2005 to 30 th May 2009. Results: The prevalence of LBW deliveries was 8.3. Of the LBW babies; 68.4 were preterm; 53.6 were small for gestational age (SGA) and 12.6 were products of multiple gestations. Predominant factors associated with LBW delivery included nulliparity; low parities (1 and 2); parturient aged 25-35 years (80.6); hypertensive disorders of pregnancy; and short birth spacing (84.4). Conclusion: Most LBW babies were preterm delivered by low parity parturient aged 25-35 years with short inter-pregnancy intervals. Effective family planning and antenatal services provided particularly for these categories of potential parturient could help to curb the incidence

Morbidity and Mortality Pattern of Neonates Admitted into Nursery Unit in Wad Medani Hospital; Sudan

Background: Neonatal outcome is an important indicator of obstetrics and health care. Few or no published data are available concerning neonatal morbidity and mortality in Sudan. Objectives: To study morbidity and mortality pattern amongst inborn neonates admitted into nursery unit in Wad Medani Hospital; Sudan during the period Jan-June; 2009. Results: A total of 1211 (29.5) out of 4098 in-born neonates were admitted during study period. The major indications for neonatal admission were; infections 300 (24.8); low birth weight (LBW) 307(25.4) and asphyxia 130(10.7). There were 133(11) neonatal deaths; preterm delivery; LBW and birth asphyxia were the major causes of death among these neonates. Conclusion: neonatal infection; preterm birth and LBW were the common causes of neonatal morbidity and mortality. There is an urgent need for more research throughout the country concerning these common causes of morbidity and mortality

Neonatal mortality and perinatal risk factors in rural south western Nigeria: a community-based prospective study

BACKGROUND: Reliable data on births and deaths particularly at the community level are scarce yet they are urgently needed to inform policy and assess the improvements which may haveoccurred with recent interventions. OBJECTIVE: To determine neonatal mortality rate and identify perinatal risk factors associated with neonatal deaths. METHODS: In a community-based prospective study, baseline data on births and deaths were collected as they occurred in a rural community of Southwest Nigeria from 1993 to 1998. Data on births and deaths were collected for the period. RESULTS: There were 972 live births and 64 infant deaths giving an infant mortality rate of 65.8 per 1000. Neonatal deaths accounted for a half of all infant deaths (N=32) giving a neonatal mortality rate of 32.9 per 1000. Twelve (37.5%) of neonatal deaths occurred on the first day of life; half of all neonatal deaths occurred within two days of birth, 21(65.6%) occurred during the first seven days of life and only 11 (34.4%) occurred over the last three weeks of the first month. The commonest known cause of death was associated with low birth weight (LBW) which was responsible for eight (25%) of deaths, while sepsis/fever and maternal deaths/failure to thrive were responsible for four (12.5%) and three (9.4%) deaths respectively. Asphyxia accounted for 3(9.4%) deaths; neonatal tetanus, congenital abnormality and diarrhoea were responsible for one (3.1%) death each. Cause of death was unclassified in many early neonatal deaths particularly those which occurred at home. Predictors of neonatal death included LBW {RR=4.7 (1.7-13.1) p=0.03},delivery outside a health facility {RR=3.6 (1.001-13.2) p=0.05},lack of attendant at delivery {RR=5.01 (1.3­19.1) p=0.018} and Traditional Birth Attendant (TBA) delivering the baby {RR=2.7 (1.1­6.4) p=0.03). Effect of sex of the neonate, mother and fathers' ages were not significant at the 5% level in the model. CONCLUSION: Neonatal deaths contribute significantly to the high infant mortality in this rural community. Services provided by TBAs are not optimal but appear to be better than having noone in attendance at delivery. TBAs therefore need to be trained to identify at risk neonates and refer. Obstetric and public health services have to be available and made more accessible at the grass root level

Risks for preterm delivery and low birth weight are independently increased by severity of maternal anaemia

Objective. To estimate the effect of the severity of maternal anaemia on various perinatal outcomes. Design. A cross-sectional study. Setting. Labour Ward; Muhimbili National Hospital; Dar es Salaam; Tanzania. Methods. The haemoglobin of eligible pregnant women admitted for delivery between 15 November 2002 and 15 February 2003 was measu- red. Data on socio-demographic characteristics; iron supplementation; malaria prophylaxis; blood transfusion during current pregnancy; and current and previous pregnancy outcomes were collected and analysed. Anaemia was classified according to the World Health Organization (WHO) standards: normal - Hb =11.0 g/dl; mild - Hb 9.0 - 10.9 g/dl; moderate - Hb 7.0 - 8.9 g/dl; and severe - Hb 7.0 g/dl. Logistic regression analysis was performed to estimate the severity of anaemia. The following outcome measures were used: preterm delivery (37 weeks); Apgar score; stillbirth; early neonatal death; low birth weight (LBW) (2 500 g) and very low birth weight (VLBW) (1 500 g). Results. A total of 1 174 anaemic and 547 non-anaemic women were enrolled. Their median age was 24 years (range 14 - 46 years) and median parity was 2 (range 0 - 17). The prevalence of anaemia and severe anaemia was 68and 5.8; respectively. The risk of preterm delivery increased significantly with the severity of anaemia; with odds ratios of 1.4; 1.4 and 4.1 respectively for mild; moderate and severe anaemia. The corresponding risks for LBW and VLBW were 1.2 and 1.7; 3.8 and 1.5; and 1.9 and 4.2 respectively. Conclusion. The risks of preterm delivery and LBW increased in proportion to the severity of maternal anaemia