Perinatal mortality in the special care nursery of Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Objectives: To determine the mortality rate and causes of death of all infants admitted to the Special Care Nursery (SCN) of a tertiary referral hospital in rural Kenya. Design: Prospective and Cross-sectional study Setting: Special Care Nursery, Moi Teaching and Referral Hospital, Eldoret, Kenya. Subjects: All infants admitted to the Special Care Nursing (SCN). Main Outcome measures: Survival status at seven postnatal days; major causes of mortality and morbidity. Results: Three hundred and thirty five babies were studied between February and September 1999. Out of these 167(49.9%) were male. There were 50(15%) preterm and 124(37.3%) low birth weight babies. There were 198(76.2%) appropriate for gestational age (AGA), 46(17.7%) small for gestational age and 16(6.2%) large for gestational age babies. The seven day mortality rate of infants admitted to the Special Care Nursery was 66(19.7%). Birth asphyxia and respiratory distress accounted for most deaths. Infants who were admitted primarily because the mother remained under general anesthesia generally did well. Logistic factors, including inadequate training for neonatal resuscitation in ward cadre of staff, unavailability of trained paediatricians and obstetricians, and inadequate operating theatre supplies were all found to delay treatment and likely to increase mortality. Conclusion: Morbidity and mortality of infants born at the MTRH remain high. The most common cause of mortality remains birth asphyxia. Some causative factors, such as lack of resources or personnel, are logistic and could be rectified. Antenatal care had a significant positive impact on both morbidity and mortality.