To study the short term outcome and risk factors for premature neonate born at Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, CG

Abstract

Background: Prematurity is the leading cause of perinatal morbidity and mortality worldwide,23 affecting 5-10% of births. Preterm neonates have a 120 times higher risk of death than neonates. The prevention of premature birth is the single most important challenge to modern obstetrics today. Progress in this area has been hampered by lack of understanding of the basic mechanisms responsible for premature labour and delivery. Thus, the following is a study on the short term outcomes and risk factors of preterm babies born at Dr B R Ambedkar Memorial hospital, conducted to evaluate the early outcomes of premature infants at the time of discharge and the identification of different risk factors for preterm births.Methods: This is a prospective hospital based observational study, conducted over a period of 1 year (March 2018 – march 2019), including a total of 1472 preterm babies. Results: A total of 1472 preterm were born during the study period. Preterm male: female was 1.1:1. Obstetrics history of mothers showed 47.35% were having parity-1, 30.71% were having parity-2. Common risk factors noted were multiple pregnancy (28.46%) followed by pre-eclampsia (27.03%). A total of 66.71% of neonates were born beyond 34 weeks of gestation, 60.46% were having birth weight between 1500 and 2499 gm, 18.14% were very low birth weight (VLBW) and 4.35% were extremely low birth weight (ELBW). A total of 545 (37.02%) required NICU admission. Major morbidities noted were respiratory distress syndrome (55.59%) followed by sepsis (30.64%), perinatal asphyxia (11.19%), neonatal jaundice (10.64%) and retinopathy of prematurity (9.91%). A negative correlation was noted between gestational age and duration of stay in NICU (r = 0.98, p = 0.022). Birth weight and gestational age of neonates were significantly associated with the treatment outcome(p=0.000). Very low birth weight neonates had highest mortality (40.85%) followed by ELBW (28.05%). Mortality of 11.14% was noted with respiratory distress syndrome (10.83%) being the major cause followed by sepsis (8.07%). Conclusions: The most common maternal risk factors noted were multiple pregnancies, preeclampsia, eclampsia, antepartum haemorrhage and gestational hypertension. Common morbidities observed in preterm babies were respiratory distress syndrome, sepsis, perinatal-asphyxia and neonatal-jaundice. The common causes of death were respiratory distress syndrome, sepsis and prematurity. Results show that preterm babies have higher risk for morbidity and mortality. Mortality decreased with increase in gestational age and birth weight.