Factors associated with the admission of moderate to late preterm and term neonates within 72 hours of birth at Dedza and Mangochi District Hospitals, Malawi: a matched case-control study.
| Autor: | Hajison PL; Pediatric And Child Health Association, PO Box 350, Chichiri, Blantyre, Malawi. precioushajison@gmail.com.; PreLuHa Consultancy, PO Box 703, Zomba, Malawi. precioushajison@gmail.com.; SHSPH University of Pretoria, Private Bag X20 Hatfield, 0028, Pretoria, South Africa. precioushajison@gmail.com., Dzikiti L; SHSPH University of Pretoria, Private Bag X20 Hatfield, 0028, Pretoria, South Africa., Chimatiro C; School of Public Health, University of Western Cape, P/BAG X17, 7535, Bellville, South Africa.; Machinga District Health Office, Administration Department, PO Box 44, Liwonde, Malawi., Tshotetsi L; Department of Clinical Associates, University of Pretoria, Private Bag X20 , Hatfield, 0028, Pretoria, South Africa., Mbale E; Pediatric And Child Health Association, PO Box 350, Chichiri, Blantyre, Malawi.; Kamuzu University of Health Sciences, , PRIVATE BAG 360, Chichiri, Blantyre , Malawi., Makhumula B; Clinical Department, Mangochi District Hospital, PO Box 42, Mangochi, Malawi., Mwanjera GE; Dedza Nursing Department, Dedza District Hospital, PO Box 136, Dedza, Malawi., Chinkonde JR; UNICEF Malawi Country Office, PO Box 30375, Lilongwe, Malawi., Senbete M; UNICEF Malawi Country Office, PO Box 30375, Lilongwe, Malawi., Nwosisi C; UNICEF Malawi Country Office, PO Box 30375, Lilongwe, Malawi., Gohar F; Maternal and Newborn Health Specialist UNICEF Eastern and Sothern Africa Region office, PO Box 44145-00100, Nairobi, Kenya., Lufesi N; Ministry of Health, Department of Curative and Medical Rehabilitation, Emergency and Disaster Response Division, Lilongwe, Malawi., Hailegebriel TD; Newborn and Adolescent Health Unit, UNICEF Head Quarters, New York, NY, 10017, USA. |
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| Jazyk: | angličtina |
| Zdroj: | BMC pediatrics [BMC Pediatr] 2024 Dec 04; Vol. 24 (1), pp. 794. Date of Electronic Publication: 2024 Dec 04. |
| DOI: | 10.1186/s12887-024-05294-w |
| Abstrakt: | Objective: To investigate the demographic characteristics, maternal, and perinatal factors associated with the hospitalization of moderate to late preterm and term neonates within 72 h of birth in the Dedza and Mangochi districts of Malawi. Methods: This case-control study was conducted with one-to-one matching for age, location, and sex. Cases were sick neonates who were admitted in the Sick Intensive Neonatal Care Unit (SINCU) within 72 h of life, while controls were non-sick neonates delivered within two weeks of the birth dates of cases. Prenatal data were extracted from case files, while other maternal practices and demographic characteristics were obtained by interviewing primary care takers or legal guardians after obtaining consent. Descriptive analyses and logistic regression were used to identify factors associated with hospitalization of moderate to late preterm and term neonates within 72 h of birth. Results: Application of tetracycline eye ointment (AOR: 0.41, 95% CI: 0.20-0.82, p = 0.012) applying chlorhexidine to the umbilical cord stump (AOR: 0.30, 95% CI: 0.10-0.88, p = 0.027), and stimulation resuscitation (AOR: 0.20, 95% CI: 0.05-0.78, p = 0.020) were associated with a reduced odd of hospitalization. An increased odds of hospitalization was significantly associated with low birth weight (AOR: 10.48, 95% CI: 4.25-25.89, p = 0.001), Apgar score < 5 (AOR: 5.0, 95% CI: 2.14-11.63, p = 0.001), suctioning resuscitation (AOR: 2.82, 95% CI: 1.17-6.83, p = 0.021), and resuscitation using O Conclusion: The research findings indicate that several interventions significantly reduce infections in neonates within their initial 72 h of life. These include the application of ophthalmic ointment to all neonates, utilization of chlorhexidine on the umbilical cord stump, and provision of antenatal treatment for syphilis and HIV in infected mothers. Conversely, certain factors increase the likelihood of neonatal morbidity and potential hospitalization during this critical period. These risk factors include low birth weight, a low Apgar score, and conditions necessitating suctioning or oxygen resuscitation at birth. Furthermore, infants born to mothers who experienced premature rupture of membranes or meconium-stained amniotic fluid during parturition are more susceptible to infectious conditions, which may necessitate hospitalization within the first 72 h postpartum. We recommend that stimulation be used as the core procedure for resuscitation, whereas suctioning should be used with caution and only when it is essential. Infection prevention measures should always be adhered to during all procedures on neonates. We recommend intensifying HIV and syphilis testing and treating during the antenatal period to reduce neonatal infection. Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was approved by National Health Sciences Research Committee (NHSRC) under registration number #21/03/2659. Written informed consent was sought from the legal guardians before the neonate was enrolled. Competing interests: Upon reviewing the journal’s guidelines, it is noted that the following authors of this manuscript have disclosed competing interests: Jacqueline Rose. Chinkonde, Mesfin Senbete, Charles Nwosisi, Fatima Gohar and Tedbabe D. Hailegebriel are affiliated with UNICEF as employees. The remaining authors have stated that they have no conflicting interests to declare. Clinical trial number: not applicable. (© 2024. The Author(s).) |
| Databáze: | MEDLINE |
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