Socio-demographic and clinical predictors of hypoxaemia among high-risk term neonates in Ilesa, Nigeria

Abstract

Background: Hypoxaemia is a common feature occurring in ill neonates. Prompt identification and intervention are important to ameliorate deleterious consequences. This study set out to determine the socio-demographic and clinical predictors of hypoxaemia among ill babies at the Wesley Guild Hospital, Ilesa, Nigeria. Patients and Methods: Term neonates admitted to the special care baby unit were consecutively recruited over a 7-month period. Peripheral oxygen saturation (SpO2) was measured at presentation using a portable pulse oximeter (Nellcor® N-200, USA), and hypoxaemia was defined as SpO2 < 90%. Relevant history and examination findings were compared among hypoxaemic and non-hypoxaemic babies. Multivariate analysis was used to identify predictors of hypoxaemia. Results: Two hundred and two babies (male-to-female ratio of 1.3:1) were recruited. The predominant presentations were perinatal asphyxia (51.5%), sepsis (31.7%) and jaundice (28.2%). Thirty-nine (19.3%) babies were hypoxaemic at admission. Female sex, infants of primigravidae, delivery outside health facilities, lack of antenatal care (ANC), grunting respiration and cyanosis were associated with hypoxaemia (P < 0.05). Grunting [odds ratios (OR) = 14.535; P < 0.001] and cyanosis at presentation (OR = 11.143; P = 0.005) independently predicted hypoxaemia. Twenty (7.5%) babies died, and hypoxaemia at presentation was significantly associated with mortality (P < 0.001). Conclusion: Hypoxaemia was common among the study participants and was significantly associated with mortality. Efforts should be made to make essential obstetric care affordable and widely available, as babies delivered outside the health facility to mothers with no ANC and those with grunting and cyanosis are at increased risk of having hypoxaemia.