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Risk factors for severe early neonatal morbidity among term neonates admitted at Muhimbili National Hospital, Tanzania - A nested case control study

Show simple item record Lijohi, F.A. 2019-02-08T13:55:34Z 2019-02-08T13:55:34Z 2015
dc.description.abstract Background Early neonatal period is the first seven days of life, and the highest risky period for adverse neonatal outcome. Worldwide about 4 million neonatal deaths occur yearly, three quarters of these deaths occur in the first week. Neonates with severe morbidity are at increased risk of mortality than the rest. Studies addressing risk factors for severe early neonatal morbidity pay more attention to premature babies with less attention to term neonates. Risk factors could differ substantially because term neonates are expected to be healthier due to their physiological maturity. Objective The focus of this study was on term babies who were admitted at MNH Neonatal Care Unit within seven days of life with the objective to identify risk factors for their severe morbidity. Methods This was a nested case control study conducted on all term neonates who were admitted within seven days of birth during the study period from September to December. We adapted the MAIN score tool as a checklist during data collection and follow up, and presence of death or any one or more of the selected morbidity items within seven days of delivery was used to distinguish between severely morbid neonates and less severely morbid neonates. Data were obtained from review of neonatal unit case notes, review of RCH4 cards, delivery records and questionnaire interviews with the mothers. Using SPSS version 20 computer program, univariate regression models were run to determine Odds ratios and 95% Confidence Intervals as estimates of the risk for severe morbidity and clinical importance of the individual risk factors respectively. Multivariate analysis was then performed to determine the independent risk factors for severe morbidity in the final Model. In all analyses the p value of 0.05 or less were taken as statistically significant. Ethical clearance for this study was obtained from MUHAS Senate Research and Publication Committee and Muhimbili National Hospital. Results During the study period a total of 2104 newborns were admitted at MNH NCU. Of these 1624 did not meet the criteria for the study. The analysis was done on 463 term neonate of whom 220(47.5%) were diagnosed to have severe early neonatal morbidity. Incidence of early neonatal morbidity for term neonates was 255.7 per 1000 neonates. Low birth weight in term babies and urinary tract infections during pregnancy were independently associated with severe early neonatal morbidity. Severe early neonatal morbidity of a term neonate with no congenital anomaly was a serious adverse outcome with high proportion at MNH, and warrants further investigations. Furthermore studies are recommended for identifications of more risk factors. en_US
dc.language.iso en en_US
dc.publisher Muhimbili University en_US
dc.subject Neonates en_US
dc.subject Tanzania en_US
dc.subject Neonatal morbidity en_US
dc.subject Risk factors en_US
dc.title Risk factors for severe early neonatal morbidity among term neonates admitted at Muhimbili National Hospital, Tanzania - A nested case control study en_US
dc.type Thesis en_US

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