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Mortality among very low birth weight infants after hospital discharge in a low resource setting

BACKGROUND: Early discharge of very low birth weight infant (VLBW) in low resource settings is inevitable but to minimize mortality of these infants after discharge we need to identify the death attributes. METHOD: A prospective cohort was conducted among 190 VLBW infants discharged from Mulago Spec...

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Autores principales: Abdallah, Yaser, Namiiro, Flavia, Nankunda, Jolly, Mugalu, Jamiru, Vaucher, Yvonne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054841/
https://www.ncbi.nlm.nih.gov/pubmed/30031387
http://dx.doi.org/10.1186/s12887-018-1226-4
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author Abdallah, Yaser
Namiiro, Flavia
Nankunda, Jolly
Mugalu, Jamiru
Vaucher, Yvonne
author_facet Abdallah, Yaser
Namiiro, Flavia
Nankunda, Jolly
Mugalu, Jamiru
Vaucher, Yvonne
author_sort Abdallah, Yaser
collection PubMed
description BACKGROUND: Early discharge of very low birth weight infant (VLBW) in low resource settings is inevitable but to minimize mortality of these infants after discharge we need to identify the death attributes. METHOD: A prospective cohort was conducted among 190 VLBW infants discharged from Mulago Special Care Baby Unit (SCBU) with discharge weight of < 1500 g over an 8 months period. These infants were followed up with the aims of determining the proportion dead 3 months after discharge, identifying factors associated and possible causes of death. Relevant data were captured, transferred in to STATA and imported to SPSS 12.0.1 for analysis. To determine factors associated with mortality bi-variable and multivariable regressions were conducted. A p-value of < 0.05 was considered significant and 95% confidence interval was used. RESULTS: Of the enrolled infants 164 (86.3%) completed follow up. The median gestational age of study participants was 32 weeks (range 26-35 weeks), the mean discharge weight was 1119 g (range 760-1470 g), and 59.8% were small for gestational age (SGA). During follow up 32 (19.5%) infants died. Infants discharged with weight of < 1200 g accounted for 81.2% of the deaths. Majority of the deaths (68.7%) occurred in the first month after discharge. Factors independently associated with mortality were discharge weight < 1000 g (OR 3.10, p 0.015) and not being SGA (OR 3.54, p 0.019). The main causes of death were presumed sepsis 50.0% and suspected cot death (25.0%). CONCLUSION: Mortality after hospital discharge among VLBW infants is high. Discharge at weight < 1200 g may not be a safe practice. Measures to prevent sepsis and suspected cot death should be addressed prior to considering early discharge of these infants.
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spelling pubmed-60548412018-07-23 Mortality among very low birth weight infants after hospital discharge in a low resource setting Abdallah, Yaser Namiiro, Flavia Nankunda, Jolly Mugalu, Jamiru Vaucher, Yvonne BMC Pediatr Research Article BACKGROUND: Early discharge of very low birth weight infant (VLBW) in low resource settings is inevitable but to minimize mortality of these infants after discharge we need to identify the death attributes. METHOD: A prospective cohort was conducted among 190 VLBW infants discharged from Mulago Special Care Baby Unit (SCBU) with discharge weight of < 1500 g over an 8 months period. These infants were followed up with the aims of determining the proportion dead 3 months after discharge, identifying factors associated and possible causes of death. Relevant data were captured, transferred in to STATA and imported to SPSS 12.0.1 for analysis. To determine factors associated with mortality bi-variable and multivariable regressions were conducted. A p-value of < 0.05 was considered significant and 95% confidence interval was used. RESULTS: Of the enrolled infants 164 (86.3%) completed follow up. The median gestational age of study participants was 32 weeks (range 26-35 weeks), the mean discharge weight was 1119 g (range 760-1470 g), and 59.8% were small for gestational age (SGA). During follow up 32 (19.5%) infants died. Infants discharged with weight of < 1200 g accounted for 81.2% of the deaths. Majority of the deaths (68.7%) occurred in the first month after discharge. Factors independently associated with mortality were discharge weight < 1000 g (OR 3.10, p 0.015) and not being SGA (OR 3.54, p 0.019). The main causes of death were presumed sepsis 50.0% and suspected cot death (25.0%). CONCLUSION: Mortality after hospital discharge among VLBW infants is high. Discharge at weight < 1200 g may not be a safe practice. Measures to prevent sepsis and suspected cot death should be addressed prior to considering early discharge of these infants. BioMed Central 2018-07-21 /pmc/articles/PMC6054841/ /pubmed/30031387 http://dx.doi.org/10.1186/s12887-018-1226-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Abdallah, Yaser
Namiiro, Flavia
Nankunda, Jolly
Mugalu, Jamiru
Vaucher, Yvonne
Mortality among very low birth weight infants after hospital discharge in a low resource setting
title Mortality among very low birth weight infants after hospital discharge in a low resource setting
title_full Mortality among very low birth weight infants after hospital discharge in a low resource setting
title_fullStr Mortality among very low birth weight infants after hospital discharge in a low resource setting
title_full_unstemmed Mortality among very low birth weight infants after hospital discharge in a low resource setting
title_short Mortality among very low birth weight infants after hospital discharge in a low resource setting
title_sort mortality among very low birth weight infants after hospital discharge in a low resource setting
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054841/
https://www.ncbi.nlm.nih.gov/pubmed/30031387
http://dx.doi.org/10.1186/s12887-018-1226-4
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