Incidence and short term outcomes of neonates with hypoxic ischemic encephalopathy in a Peri Urban teaching hospital, Uganda: a prospective cohort study

Hellen Namusoke,Maria Musoke Nannyonga,Robert Ssebunya,Edison Mworozi,Victoria Kirabira Nakibuuka

doi:10.1186/s40748-018-0074-4

Abstract

BackgroundHypoxic Ischemic Encephalopathy carries high case fatality rates ranging between 10–60%, with 25% of survivors have an adverse long-term neurodevelopment outcome. Despite the above, there is paucity of data regarding its magnitude and short term outcomes in a low resource setting like Uganda. Therefore we set out to determine the incidence and short term outcomes of Newborns with Hypoxic Ischemic Encephalopathy at St.Francis Hospital, Nsambya.MethodsThis was a Prospective Cohort study conducted between October 2015 and January 2016 at St. Francis Hospital, Nsambya, Kampala- Uganda. Term Newborn babies were enrolled. Umbilical cord arterial blood gas analysis was done for Newborns with low Apgar scores at 5 min. Clinical examination was done on all newborns within 48 h of life, for features of encephalopathy. Neonates with Hypoxic Ischemic Encephalopathy were followed up by a daily clinical examination and a short term outcome was recorded on day seven.ResultsThe incidence of Hypoxic Ischemic Encephalopathy was 30.6 cases per 1000 live births. The majority, 10 (43.5%) had mild Hypoxic Ischemic Encephalopathy, followed by 8 (34.8%), 5 (21.7%) that had moderate and severe Hypoxic Ischemic Encephalopathy respectively. A total of (6) 26% died, and (15) 65.2% were discharged within 1 week. Lack of a nutritive suckling reflex (nasogastric feeding), poor Moro reflex, and requirement for respiratory support (oxygen therapy by nasal prongs) were the common complications by day seven.ConclusionsThe burden of Hypoxic Ischemic Encephalopathy is high with a case fatality rate of 26%. There is need to conduct a longitudinal study to determine the long term complications of HIE.

Highlights

Hypoxic Ischemic Encephalopathy carries high case fatality rates ranging between 10–60%, with 25% of survivors have an adverse long-term neurodevelopment outcome
This study is aimed at determining the incidence, and short term outcomes of Hypoxic Ischemic Encephalopathy (HIE) among inborn term neonates at a tertiary hospital
Clinical examination was done on all newborns within 48 h of life, to assess for features of encephalopathy

Summary

Introduction

Hypoxic Ischemic Encephalopathy carries high case fatality rates ranging between 10–60%, with 25% of survivors have an adverse long-term neurodevelopment outcome. There is paucity of data regarding its magnitude and short term outcomes in a low resource setting like Uganda. We set out to determine the incidence and short term outcomes of Newborns with Hypoxic Ischemic Encephalopathy at St. Francis Hospital, Nsambya. Intrapartum asphyxia and consequential Hypoxic Ischemic Encephalopathy (HIE) is a common cause of potentially avoidable neonatal brain injury and mortality [3]. Different measures are being taken to reduce neonatal mortality and morbidity. These include preventive measures such as; proper monitoring of labor with a partograph, timely and adequate resuscitation and therapeutic hypothermia of Newborns with HIE to improve outcome [5]. This study is aimed at determining the incidence, and short term outcomes of HIE among inborn term neonates at a tertiary hospital

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