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Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period
Neonatal encephalopathy (NE) accounts for ~23% of the 2.4 million annual global neonatal deaths. Approximately 99% of global neonatal deaths occur in low-resource settings, however, accurate data from these low-resource settings are scarce. We reviewed risk factors of neonatal mortality in neonates...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021203/ https://www.ncbi.nlm.nih.gov/pubmed/36962805 http://dx.doi.org/10.1371/journal.pgph.0000911 |
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author | Gannon, Hannah Chimhini, Gwendoline Cortina-Borja, Mario Chiyaka, Tarisai Mangiza, Marcia Fitzgerald, Felicity Heys, Michelle Neal, Samuel R. Chimhuya, Simbarashe |
author_facet | Gannon, Hannah Chimhini, Gwendoline Cortina-Borja, Mario Chiyaka, Tarisai Mangiza, Marcia Fitzgerald, Felicity Heys, Michelle Neal, Samuel R. Chimhuya, Simbarashe |
author_sort | Gannon, Hannah |
collection | PubMed |
description | Neonatal encephalopathy (NE) accounts for ~23% of the 2.4 million annual global neonatal deaths. Approximately 99% of global neonatal deaths occur in low-resource settings, however, accurate data from these low-resource settings are scarce. We reviewed risk factors of neonatal mortality in neonates admitted with neonatal encephalopathy from a tertiary neonatal unit in Zimbabwe. A retrospective review of risk factors of short-term neonatal encephalopathy mortality was conducted at Sally Mugabe Central Hospital (SMCH) (November 2018 –October 2019). Data were gathered using a tablet-based data capture and quality improvement newborn care application (Neotree). Analyses were performed on data from all admitted neonates with a diagnosis of neonatal encephalopathy, incorporating maternal, intrapartum, and neonatal risk predictors of the primary outcome: mortality. 494/2894 neonates had neonatal encephalopathy on admission and were included. Of these, 94 died giving a neonatal encephalopathy-case fatality rate (CFR) of 190 per 1000 admitted neonates. Caesarean section (odds ratio (OR) 2.95(95% confidence interval (CI) 1.39–6.25), convulsions (OR 7.13 (1.41–36.1)), lethargy (OR 3.13 (1.24–7.91)), Thompson score “11–14” (OR 2.98 (1.08–8.22)) or “15–22” (OR 17.61 (1.74–178.0)) were significantly associated with neonatal death. No maternal risk factors were associated with mortality. Nearly 1 in 5 neonates diagnosed with neonatal encephalopathy died before discharge, similar to other low-resource settings but more than in typical high-resource centres. The Thompson score, a validated, sensitive and specific tool for diagnosing neonates with neonatal encephalopathy was an appropriate predictive clinical scoring system to identify at risk neonates in this setting. On univariable analysis time-period, specifically a period of staff shortages due to industrial action, had a significant impact on neonatal encephalopathy mortality. Emergency caesarean section was associated with increased mortality, suggesting perinatal care is likely to be a key moment for future interventions. |
format | Online Article Text |
id | pubmed-10021203 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-100212032023-03-17 Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period Gannon, Hannah Chimhini, Gwendoline Cortina-Borja, Mario Chiyaka, Tarisai Mangiza, Marcia Fitzgerald, Felicity Heys, Michelle Neal, Samuel R. Chimhuya, Simbarashe PLOS Glob Public Health Research Article Neonatal encephalopathy (NE) accounts for ~23% of the 2.4 million annual global neonatal deaths. Approximately 99% of global neonatal deaths occur in low-resource settings, however, accurate data from these low-resource settings are scarce. We reviewed risk factors of neonatal mortality in neonates admitted with neonatal encephalopathy from a tertiary neonatal unit in Zimbabwe. A retrospective review of risk factors of short-term neonatal encephalopathy mortality was conducted at Sally Mugabe Central Hospital (SMCH) (November 2018 –October 2019). Data were gathered using a tablet-based data capture and quality improvement newborn care application (Neotree). Analyses were performed on data from all admitted neonates with a diagnosis of neonatal encephalopathy, incorporating maternal, intrapartum, and neonatal risk predictors of the primary outcome: mortality. 494/2894 neonates had neonatal encephalopathy on admission and were included. Of these, 94 died giving a neonatal encephalopathy-case fatality rate (CFR) of 190 per 1000 admitted neonates. Caesarean section (odds ratio (OR) 2.95(95% confidence interval (CI) 1.39–6.25), convulsions (OR 7.13 (1.41–36.1)), lethargy (OR 3.13 (1.24–7.91)), Thompson score “11–14” (OR 2.98 (1.08–8.22)) or “15–22” (OR 17.61 (1.74–178.0)) were significantly associated with neonatal death. No maternal risk factors were associated with mortality. Nearly 1 in 5 neonates diagnosed with neonatal encephalopathy died before discharge, similar to other low-resource settings but more than in typical high-resource centres. The Thompson score, a validated, sensitive and specific tool for diagnosing neonates with neonatal encephalopathy was an appropriate predictive clinical scoring system to identify at risk neonates in this setting. On univariable analysis time-period, specifically a period of staff shortages due to industrial action, had a significant impact on neonatal encephalopathy mortality. Emergency caesarean section was associated with increased mortality, suggesting perinatal care is likely to be a key moment for future interventions. Public Library of Science 2022-12-20 /pmc/articles/PMC10021203/ /pubmed/36962805 http://dx.doi.org/10.1371/journal.pgph.0000911 Text en © 2022 Gannon et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Gannon, Hannah Chimhini, Gwendoline Cortina-Borja, Mario Chiyaka, Tarisai Mangiza, Marcia Fitzgerald, Felicity Heys, Michelle Neal, Samuel R. Chimhuya, Simbarashe Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period |
title | Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period |
title_full | Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period |
title_fullStr | Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period |
title_full_unstemmed | Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period |
title_short | Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period |
title_sort | risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in zimbabwe over a 12-month period |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021203/ https://www.ncbi.nlm.nih.gov/pubmed/36962805 http://dx.doi.org/10.1371/journal.pgph.0000911 |
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