Outcomes and associated factors among premature neonates with respiratory distress syndrome managed at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: Globally, approximately over 4 million newborns die annually and the leading cause of death is directly from preterm complications which account for more than 1 million deaths. The most common complication is Respiratory distress syndrome (RDS). Objective: To determine short-term outcomes of premature neonates with RDS managed in the newborn unit (NBU) at Moi Teaching & Referral Hospital (MTRH), Eldoret. Design: Prospective descriptive study. Setting: Riley Mother Baby Hospital, NBU (MTRH), Eldoret. Participants: All admitted premature neonates clinically diagnosed with RDS. Main outcomes: Death/survival on day 10 and broncho-pulmonary dysplasia (BPD) at 6 weeks. Results: This study enrolled 94 premature neonates with RDS and 54 (57.4%) were females. Gestational age distribution: Below 28weeks (7.5%), 28-32weeks (54.3%) and 33-37 weeks (38.3%). Continuous Positive Airway Pressure was used on 62.8% (95% CI 52.2, 72.5), the rest received oxygen via nasal prongs and none received surfactant. Mortality at day 10 was 61% (0.61 95% CI: 0.51,0.71) with BPD reported in one neonate at 6weeks. Survival was 40% and 25% on day 10 and 40 respectively. Hypothermia and hyperglycemia were found in 65% and 55% respectively whereas suspected sepsis was treated in 77 (81.9%) of the neonates. None of the factors were independently associated with the outcome of death after adjusting by multiple logistic regression. Conclusion: There was a high mortality mainly occurring in the first 10 days of life. Hypothermia, hyperglycemia and neonatal sepsis were common co-morbidities. None of the factors were independently associated with the outcome of death. Chronic complications like BPD were rare.