article · Pediatric Health Medicine and Therapeutics
Low birth weight infants face serious health risks due to physical immaturity, contributing substantially to global infant deaths. A retrospective study of 718 low birth weight neonates admitted to a specialised neonatal intensive care unit between 2017 and 2019 revealed an overall mortality incidence density of 35.3 per 1000 person-days. Approximately two in every seven infants died during the follow-up period. Key factors linked to a higher risk of death included delivery outside health facilities, maternal age under 18 or over 35 years, and an extremely low birth weight of less than 1000 grams. Clinical conditions such as neonatal sepsis, respiratory distress syndrome, and necrotising enterocolitis also significantly increased the likelihood of mortality. Addressing these specific clinical conditions through early diagnosis and targeted clinical care, alongside maternal counselling on age-related risks, is vital for improving newborn survival.
Low birth weight is responsible for the majority of newborn deaths worldwide. Identifying the specific clinical and maternal factors that drive mortality in hospital settings enables medical staff and health planners to target resources effectively. Early detection of severe complications and improved care during delivery can directly save the lives of vulnerable newborns in intensive care.
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BACKGROUND: Low birth weight neonates are subjected to different comorbidities due to anatomical and physiological immaturity. Globally, 60-80% of neonatal mortality was due to low birth weight. Hence, this study aimed to assess the survival status and predictors of mortality among low birth weight neonates. METHODS: An institutional-based retrospective cohort study design was conducted among 718 low birth weight neonates admitted to the neonatal intensive care unit from January 1, 2017, to December 30, 2019, at Felege Hiwot Comprehensive Specialized Hospital. Data were entered into Epi data version 3.1 and analyzed with STATA version 14. Kaplan-Meier curves together with a Log rank test were used to estimate the survival time and showed the presence of differences among groups. Cox proportional-hazard regression was used to estimate the hazard ratio at the 5% level of significance to determine the net effect of each explanatory variable on survival status. RESULTS: The overall incidence density was 35.3 per 1000 person-day observations (CI: 30.8 -40.6) with 5715 follow-up days. Deliveries outside the health institution [AHR; 2.31 (95% CI: 1.20-4.42)], maternal age <18 years [AHR; 3.08 (95% CI: 1.64-5.81)] and maternal age >35 years [AHR; 3.83 (95% CI: 2.00-7.31)], neonatal sepsis [AHR; 2.33 (95% CI: 1.38-3.94)], neonatal respiratory distress syndrome [AHR; 1.92 (95% CI: 1.27-2.89)], necrotizing enterocolitis [AHR; 3.09 (95% CI: 1.69-5.64)] and birth weight <1000 gm [AHR; 3.61 (95% CI: 1.73-7.55)] were found to be significant predictors. CONCLUSION: This study showed that two of the seven low birth weight neonates died during the follow-up period. Therefore, it is better for health care providers and other stakeholders to focus more on early diagnosis and management of low birth weight neonates with sepsis, respiratory distress syndrome, necrotizing enterocolitis and counseling mothers on the risk of having a child in early and old age.
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DOI: 10.2147/phmt.s323526
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