International Journal of Biomedical Engineering and Clinical Science

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Determinants of Neonatal Outcomes for Preterm Infants Admitted to the Neonatal Intensive Care Unit at Ndola Teaching Hospital in Ndola District, Zambia

Received: 28 September 2023    Accepted: 20 October 2023    Published: 6 December 2023
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Abstract

Neonatal outcomes for preterm infants vary from region to region in the world. In the last few decades, there have been major improvements in neonatal outcomes of premature infants in the developed countries; but not so much in developing countries. In Zambia, the preterm birth rate is estimated to be 13% of all births, and each year there are 77, 600 preterm births of which 6,800 die due to preterm complications. Preterm birth complications are the leading cause of death among children under 5 years of age and many survivors face a lifetime of disability. This study was aimed at identifying determinants of neonatal outcomes for preterm infants admitted to the NICU at Ndola Teaching Hospital. The research design employed was the quantitative with an observational, panel longitudinal approach. Conducted from February, 2021 to June 2021. Study participants were selected using convenience sampling. The sample size was 173 but two were lost to follow-up, out of these, 108 were successfully discharged from hospital, eight survived with complications and 55 died within the neonatal period. Data were analysed using SPSS version 23 Software and presented in table forms. The determinants of neonatal outcomes were examined using, Chi-square test and multivariate multinomial logistic regression to control for confounders. Findings revealed that infants who were born by caesarean section had 54.93% chances of survival compared to those who underwent vaginal delivery. Infants nursed in incubators were at higher risk of dying and developing complications, compared to those who were not, with p-value <.0001. Infants with 4-10 Apgar scores were less likely (OR = 0.170 (95% CI = [0, 0.675]) and 0.053 (95% CI = [1.238, 0.0755]) to develop complications and less likely (OR = 0.053, (95% CI = [0.038, 0.19]) and (OR = 0.106, 95% CI = 0.017, 0.741]) to die within the neonatal period, than those with 0-3 Apgar score. Preterm infants with birth weights greater than 1,500 grams were less likely (OR = 0.209, 95%CI = [0.059, 0.741]) to die during the neonatal period compared to those weighing between 500 to 1500 grams. Service and health related factors such as failure to suction the infant at birth when needed, nursing infants in incubators, low birth weight and low Apgar score at one and five minutes were determinants of poor neonatal outcomes. In order to improve survival rates for preterm infants, interventions should be directed on the mentioned factors in their management.

DOI 10.11648/j.ijbecs.20230904.12
Published in International Journal of Biomedical Engineering and Clinical Science (Volume 9, Issue 4, December 2023)
Page(s) 75-84
Creative Commons

This is an Open Access article, 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 or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Determinants, Preterm Infants, Neonatal Outcomes, Neonatal Intensive Care Unit

References
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    Hyascinth Mbulo, N., Mwaba Chileshe, S., Namukolo Concepta, K. (2023). Determinants of Neonatal Outcomes for Preterm Infants Admitted to the Neonatal Intensive Care Unit at Ndola Teaching Hospital in Ndola District, Zambia. International Journal of Biomedical Engineering and Clinical Science, 9(4), 75-84. https://doi.org/10.11648/j.ijbecs.20230904.12

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    Hyascinth Mbulo, N.; Mwaba Chileshe, S.; Namukolo Concepta, K. Determinants of Neonatal Outcomes for Preterm Infants Admitted to the Neonatal Intensive Care Unit at Ndola Teaching Hospital in Ndola District, Zambia. Int. J. Biomed. Eng. Clin. Sci. 2023, 9(4), 75-84. doi: 10.11648/j.ijbecs.20230904.12

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    AMA Style

    Hyascinth Mbulo N, Mwaba Chileshe S, Namukolo Concepta K. Determinants of Neonatal Outcomes for Preterm Infants Admitted to the Neonatal Intensive Care Unit at Ndola Teaching Hospital in Ndola District, Zambia. Int J Biomed Eng Clin Sci. 2023;9(4):75-84. doi: 10.11648/j.ijbecs.20230904.12

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  • @article{10.11648/j.ijbecs.20230904.12,
      author = {Nsululu Hyascinth Mbulo and Siwale Mwaba Chileshe and Kwaleyela Namukolo Concepta},
      title = {Determinants of Neonatal Outcomes for Preterm Infants Admitted to the Neonatal Intensive Care Unit at Ndola Teaching Hospital in Ndola District, Zambia},
      journal = {International Journal of Biomedical Engineering and Clinical Science},
      volume = {9},
      number = {4},
      pages = {75-84},
      doi = {10.11648/j.ijbecs.20230904.12},
      url = {https://doi.org/10.11648/j.ijbecs.20230904.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbecs.20230904.12},
      abstract = {Neonatal outcomes for preterm infants vary from region to region in the world. In the last few decades, there have been major improvements in neonatal outcomes of premature infants in the developed countries; but not so much in developing countries. In Zambia, the preterm birth rate is estimated to be 13% of all births, and each year there are 77, 600 preterm births of which 6,800 die due to preterm complications. Preterm birth complications are the leading cause of death among children under 5 years of age and many survivors face a lifetime of disability. This study was aimed at identifying determinants of neonatal outcomes for preterm infants admitted to the NICU at Ndola Teaching Hospital. The research design employed was the quantitative with an observational, panel longitudinal approach. Conducted from February, 2021 to June 2021. Study participants were selected using convenience sampling. The sample size was 173 but two were lost to follow-up, out of these, 108 were successfully discharged from hospital, eight survived with complications and 55 died within the neonatal period. Data were analysed using SPSS version 23 Software and presented in table forms. The determinants of neonatal outcomes were examined using, Chi-square test and multivariate multinomial logistic regression to control for confounders. Findings revealed that infants who were born by caesarean section had 54.93% chances of survival compared to those who underwent vaginal delivery. Infants nursed in incubators were at higher risk of dying and developing complications, compared to those who were not, with p-value <.0001. Infants with 4-10 Apgar scores were less likely (OR = 0.170 (95% CI = [0, 0.675]) and 0.053 (95% CI = [1.238, 0.0755]) to develop complications and less likely (OR = 0.053, (95% CI = [0.038, 0.19]) and (OR = 0.106, 95% CI = 0.017, 0.741]) to die within the neonatal period, than those with 0-3 Apgar score. Preterm infants with birth weights greater than 1,500 grams were less likely (OR = 0.209, 95%CI = [0.059, 0.741]) to die during the neonatal period compared to those weighing between 500 to 1500 grams. Service and health related factors such as failure to suction the infant at birth when needed, nursing infants in incubators, low birth weight and low Apgar score at one and five minutes were determinants of poor neonatal outcomes. In order to improve survival rates for preterm infants, interventions should be directed on the mentioned factors in their management.
    },
     year = {2023}
    }
    

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    T1  - Determinants of Neonatal Outcomes for Preterm Infants Admitted to the Neonatal Intensive Care Unit at Ndola Teaching Hospital in Ndola District, Zambia
    AU  - Nsululu Hyascinth Mbulo
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    AU  - Kwaleyela Namukolo Concepta
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    DO  - 10.11648/j.ijbecs.20230904.12
    T2  - International Journal of Biomedical Engineering and Clinical Science
    JF  - International Journal of Biomedical Engineering and Clinical Science
    JO  - International Journal of Biomedical Engineering and Clinical Science
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    AB  - Neonatal outcomes for preterm infants vary from region to region in the world. In the last few decades, there have been major improvements in neonatal outcomes of premature infants in the developed countries; but not so much in developing countries. In Zambia, the preterm birth rate is estimated to be 13% of all births, and each year there are 77, 600 preterm births of which 6,800 die due to preterm complications. Preterm birth complications are the leading cause of death among children under 5 years of age and many survivors face a lifetime of disability. This study was aimed at identifying determinants of neonatal outcomes for preterm infants admitted to the NICU at Ndola Teaching Hospital. The research design employed was the quantitative with an observational, panel longitudinal approach. Conducted from February, 2021 to June 2021. Study participants were selected using convenience sampling. The sample size was 173 but two were lost to follow-up, out of these, 108 were successfully discharged from hospital, eight survived with complications and 55 died within the neonatal period. Data were analysed using SPSS version 23 Software and presented in table forms. The determinants of neonatal outcomes were examined using, Chi-square test and multivariate multinomial logistic regression to control for confounders. Findings revealed that infants who were born by caesarean section had 54.93% chances of survival compared to those who underwent vaginal delivery. Infants nursed in incubators were at higher risk of dying and developing complications, compared to those who were not, with p-value <.0001. Infants with 4-10 Apgar scores were less likely (OR = 0.170 (95% CI = [0, 0.675]) and 0.053 (95% CI = [1.238, 0.0755]) to develop complications and less likely (OR = 0.053, (95% CI = [0.038, 0.19]) and (OR = 0.106, 95% CI = 0.017, 0.741]) to die within the neonatal period, than those with 0-3 Apgar score. Preterm infants with birth weights greater than 1,500 grams were less likely (OR = 0.209, 95%CI = [0.059, 0.741]) to die during the neonatal period compared to those weighing between 500 to 1500 grams. Service and health related factors such as failure to suction the infant at birth when needed, nursing infants in incubators, low birth weight and low Apgar score at one and five minutes were determinants of poor neonatal outcomes. In order to improve survival rates for preterm infants, interventions should be directed on the mentioned factors in their management.
    
    VL  - 9
    IS  - 4
    ER  - 

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Author Information
  • Department of Midwifery and Women Health, School of Nursing Sciences, University of Zambia, Lusaka, Zambia

  • Department of Midwifery and Women Health, School of Nursing Sciences, University of Zambia, Lusaka, Zambia

  • School of Nursing and Midwifery, Mulungushi University, Kabwe, Zambia

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