Outcome of Very Premature Newborns in a Referral Hospital in a Resource-Limited Setting

Abstract

Background: In Cameroon, prematurity is considered among the first cause of neonatal mortality and the main cause of sequelae in children under 5 years old. Although some local teams have studied the causes of neonatal deaths, the survival of the very preterm babies in our context remains poorly known. Patients and Methods: We conducted a hospital-based cross-sectional study with both a retrospective and prospective data collection, covering a period of 5 years and 8 months, including 120 participants who presented with very preterm birth. Socio-demographic, anamnestic, and outcome features were studied. The assessment of the child’s psychomotor development was evaluated trough gross motor skills, fine motor skills, language and social contact. We calculated the development quotient (DQ) by dividing the developmental age (DA) by the actual age (RA) of the patient. Qualitative variables were expressed as numbers and percentages and quantitative variables as means ± standard deviations. Results: At the clinic, 23.8% of the children developed cerebral palsy, 3.1% had cerebral palsy with mental delay, and 6.6% had praxis disorders. Hearing impairment was observed in 6.3% of the survivors, visual impairment in 9%, and swallowing disorders in 7.6%. The mean developmental quotient was (89.98 ± 19.7) with a median of 93. A delay in developmental milestones was observed in 10.8%, speech disorder in 57%, severe malnutrition in 7.7%. The mortality rate was 48.5%. Conclusion: Very preterm birth is associated with a higher risk of neonatal death. Cognitive and motor disorders should not be underestimated. The harmonised management of very premature babies is highly recommended in our context for early diagnosis of sequelae.