A five-year review of the morbidity and mortality pattern in the special care baby unit of a private-owned tertiary hospital in Nigeria.

Abstract

Introduction: neonatal mortality in Nigeria is still high and the primary causes are largely preventable. The study was carried out to assess the pattern of morbidity and mortality among hospitalized Nigerian neonates.

Methods: a retrospective study was carried out on neonates admitted into the Special Care Baby Unit of the Babcock University Teaching Hospital, Ilishan-Remo, over five years between January 2014 and December 2018. The patients´ case files were retrieved from the health records unit and relevant information on their morbidities and outcomes were extracted. Bivariate analyses and logistic regression analyses were done to determine factors associated with mortality.

Results: a total of 490 babies were studied, of which 276 (56.3%) were males. Nearly two-thirds of the babies were inborn (309; 63.1%), 344 (70.2%) were delivered at term, and 136 (27.8%) were low birth weight babies. The median gestational age at birth was 37 weeks. Perinatal asphyxia was the most common diagnosis necessitating admission (104; 21.2%), closely followed by neonatal jaundice. Sepsis and prematurity were also common diagnoses. Mortality occurred in 39 (8.0%) babies; the highest case fatality rates were recorded among preterm babies (13/70; 18.6%) and those who had perinatal asphyxia (16/104; 15.4%). On logistic regression analysis, outborn status (aOR= 2.51, 95% CI= 1.26 - 5.01, p= 0.009) and preterm delivery (aOR= 4.10, 95% CI= 2.06 - 8.16, p<0.001) had significant independent association with mortality.

Conclusion: perinatal asphyxia and prematurity were the leading causes of death among the neonates studied. Efforts to reduce neonatal mortality by preventing these morbidities and promptly initiating appropriate treatment, when present, should be heightened to reduce neonatal mortality.