Factors contributing to morbidity and mortality among preterm neonates admitted at two major hospitals in Rwanda

Abstract

Background: Prematurity is one of the highest global health challenges of the 21st century and has been named the first killer of young children. In Rwanda, it is the leading cause of death in neonates. It is expedient to explore the factors contributing to the observed high morbidity and mortality to plan appropriate interventions. Objective: To identify factors contributing to morbidity and mortality among preterm neonates and neonatal outcomes at discharge. Methodology: Adopting the descriptive design and quantitative approach, 125 preterm babies admitted in the Neonatal Intensive Care Unit (NICU) of the University Teaching Hospital of Kigali and Muhima hospital over eight weeks were recruited in the study using consecutive sampling method. Interviewer administered questionnaire to the mothers, files of mothers and babies were used as sources of data. Frequencies, chi-square, and logistic regression were used for analysis. A p-value <0.05 was considered significant. Results: Marital status of mothers, mother‟s participation in the care of her baby, and APGAR score ≤ 6 with a p-value (0.007), (0.02), (0.002) respectively, were statistically significantly associated with mortality. Controlling for confounders, neonates with APGAR score ≥ 6 had a lower odds of dying compared to those with an APGAR score ≤ 6 (OR=0.268 CI:0.102,0.700). Morbidities and mortality was high as gestational age, and birth weight decreased. The main morbidities were neonatal sepsis (88.8%), and Respiratory Distress Syndrome (RDS) (62.4%). Conclusion: Characteristics of preterm neonates, care received by baby, maternal and obstetrical characteristics are critical factors thereafter neonatal sepsis and RDS accounting for highest morbidities in preterm babies.