Neonatal Death in Low Birth Weight Infants in Basrah Maternity & Children Hospital at 2008

Abstract

Background :Low birth weight) less than 2500 grams) that includes preterm birth and small for gestational age, is regarded as important causes of neonatal deaths and contributes to 60% to 80% of all neonatal deaths.Objectives :to assess the frequency of deaths in low birth weight neonates and it’s relation to selected neonatal, labour and maternal characteristics.Patients and Methods :A prospective study was carried out on low birth weight newborns admitted to neonatal care units in Basrah Maternity and Children Hospital for four months( from 1st of February till the end of the May 2008) on 508 newborns with low birth weight out of 1338 neonates admitted during the study period. One hundered-ninty one (191) neonates with low birth weight died, their death was studied in relation to neonatal, labour, delivery and maternal characteristics from data collection by special questionnaire.Results :It was found that (68.95%) of total deaths had low birth weight, male to female ratio was (1.4:1). The death was significantly related to gestational age, weight, growth status (being small for gestational age) and male sex. (P value was<0.001). The most common causes of deaths were respiratory distress syndrome (54.97%) followed by sepsis (19.37%. Other neonatal characteristics like postnatal referral, early death, and hospitalization period of less than seven days, need for resuscitation at time of birth and multiple pregnancies were associated with increased risk of death. (P value <0.001).Hospital delivery, non-complicated delivery and normal vaginal deliveries were associated with decreasing neonatal mortalities.(P value <.001).Young age mothers (less than twenty years), Primgravidae, those who had anemia in pregnancy or had poor antenatal care were more liable to have neonatal death ,while mortality rate was significantly lower among breastfed neonates compared to formula fed babies.Conclusions :The frequency of low birth weight and their deaths were high, the death was related to weight, gestational age, growth status, early neonatal period, complicated labour, caesarean section, young primi mother and maternal anemia. Prevention of prematurity and intrauterine growth retardation causes by good antenatal care, skilled attendance at births, and availability of surfactant therapy can reduce mortality.