Pulmonary hemorrhage and associated risk factors among newborns admitted to a tertiary level neonatal unit in Botswana.

Autor:	Gezmu AM; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana., Tefera E; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana., Mochankana K; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana., Imran F; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana., Joel D; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana., Pelaelo I; Department of Paediatrics, Princess Marina Hospital Botswana MOH, Gaborone, Botswana., Nakstad B; Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana.; Division of Paediatric and Adolescent Medicine, Inst Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2023 Jun 14; Vol. 11, pp. 1171223. Date of Electronic Publication: 2023 Jun 14 (Print Publication: 2023).
DOI:	10.3389/fped.2023.1171223
Abstrakt:	Introduction: Pulmonary hemorrhage (PH) is a life-threatening complication seen in very sick newborns with high morbidity and mortality. There is little data on the incidence, risk factors, and ultimate survival of newborns with pulmonary hemorrhage in sub-Saharan countries, where the healthcare provision and facility differ in many ways compared to high-income countries. Hence, this study aimed to determine the incidence, identify the risk factors, and describe the outcome of pulmonary hemorrhage in newborns in a low middle income country setting. Methods and Materials: A cohort study with prospective data collection was conducted in a public, tertiary-level hospital in Botswana, the Princess Marina Hospital (PMH). All newborns admitted to the neonatal unit from 1 January 2020 to 31 December 2021 were included in the study. Data were collected using a checklist developed on the RedCap database (https//:ehealth.ub.ac.bw/redcap). The incidence rate of pulmonary hemorrhage was calculated as the number of newborns who had pulmonary hemorrhage per 1,000 newborns in the 2-year period. Group comparisons were made using X 2 and Student's t -tests. Multivariate logistic regression was used to identify risk factors independently associated with pulmonary hemorrhage. Result: There were 1,350 newborns enrolled during the study period, of which 729 were male newborns (54%). The mean (SD) birth weight was 2,154(±997.5) g, and the gestational age was 34.3 (±4.7) weeks. In addition, 80% of the newborns were delivered in the same facility. The incidence of pulmonary hemorrhage was 54/1,350 {4% [95% CI (3%-5.2%)]} among the newborns admitted to the unit. The mortality rate in those diagnosed with pulmonary hemorrhage was 29/54 (53.7%). Multivariate logistic regression identified birth weight, anemia, sepsis, shock, disseminated intravascular coagulopathy (DIC), apnea of prematurity, neonatal encephalopathy, intraventricular hemorrhage, mechanical ventilation, and blood transfusion as risk factors independently associated with pulmonary hemorrhage. Conclusion: This cohort study identified a high incidence and mortality rate of pulmonary hemorrhage in newborns in PMH. Multiple risk factors, such as low birth weight, anemia, blood transfusion, apnea of prematurity, neonatal encephalopathy, intraventricular hemorrhage, sepsis, shock, DIC, and mechanical ventilation, were identified as independently associated risk factors for PH. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Gezmu, Tefera, Mochankana, Imran, Joel, Pelaelo and Nakstad.)
Databáze:	MEDLINE
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