A 6‑year review of neonatal emergencies and outcome in a secondary health‑care centre in Benin City, Nigeria
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Abstract
Background: An important indicator of quality health care is neonatal outcome. Few published data are available concerning neonatal emergencies and their outcome from secondary health centres, where a large number of newborns are seen.
Aim: To evaluate the neonatal emergencies, their outcome and case fatality rates (CFRs) as well as the trend of annual mortality rate in the neonatal unit (NNU) of a secondary health facility.
Methods: This retrospective study which covered a period of six years (July 2008 – June 2014) was carried out at Stella Obasanjo Hospital (SOH), a state-owned general hospital in Benin City, Edo State, Nigeria. It involved the extraction of information on patient’s age, sex, diagnosis, duration of hospital stay and outcome from the medical records of the neonatal unit.
Results: There were 2,302 newborns admitted; out of which 1,283 (55.7%) were males, while 1,019 (44.3%) were females; male: female ratio of 1.3:1. The major emergencies were neonatal sepsis [NNS] (61.9%), severe birth asphyxia [SBA] (40.9%), neonatal jaundice [NNJ] (24.5%) and prematurity (16.4%) occurring singly or in various combinations. Mortality rate was 12.8% with major contributions from NNS, SBA and prematurity. Majority (93.6%) of the deaths occurred in the first week of life. Extremely low birth weight (ELBW) babies,
neonatal tetanus (NNT) and meconium aspiration syndrome (MAS) had the highest CFRs of 52.6%, 38.7%, and 23.5%, respectively. There was a downward trend in the annual mortality rates. Significant predictors of mortality were NNJ (p=0.000), SBA (p=0.002), NNT (p=0.000), MAS (p=0.002), prematurity (p=0.000) and ELBW (p=0.000).
Conclusion: The emergencies noted among the newborns were mainly from preventable causes. These were also the main causes of mortality. To improve our health indices, we must educate mothers at the community level on common neonatal emergencies and proven preventive measures, while strengthening our obstetric and perinatal care services.
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