The immediate prospects, problems and perils of sixty-seven low birth weight babies.

Abstract

67 low birth weight babies admitted to the neonatal unit (Hurford Ward) of the Wesley Guild Hospital Ilesa between January and December 1979 are reviewed. Overall mortality was 43.4%. The shorter the gestational age the smaller the birth weight and the lower the Apgar score the higher the mortality figures. Mortality from low Apgar score can be reduced by wide scale antenatal care and screening for high risk pregnancies coupled with effective management of delivery. Infection was responsible for 34.5% of all 29 deaths. In combating infections present efforts should be directed to improved water supply and methods of delivery environmental sanitation and health education rather than costly antibiotics. Recurrent apnea of whatever origin was associated with death in 16 of the 17 babies and was diagnosed in 55.2% of all deaths. Mothers observe their babies and report abnormalities. Resources now invested in equipment can be more profitably spent on recruiting and training auxiliaries who can augment and coordinate the efforts of the mothers institute remedial action on any observed abnormalities and combine other duties like feeding and weighing. 60% (24) of the 40 babies we diagnosed with hypothermia died because of malfunctioning incubators. Efforts can be more profitably directed towards health education of the birth attendants in the surrounding maternity centers; immediate care and steps necessary to prevent hypothermia in low birth weight babies include judicious use of hot water bottles and blankets. Efforts should be directed towards improving the Wesley Guild incubator. There is an urgent need to develop simple and appropriate intermediate technology in answer to the problems raised by poverty lack of technological expertise and the absence of basic infrastructural facilities in developing countries.