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. 2022 Sep 16:10:930338.
doi: 10.3389/fped.2022.930338. eCollection 2022.

Factors influencing survival and short-term outcomes of very low birth weight infants in a tertiary hospital in Johannesburg

Kristin Ingemyr  1 , Anders Elfvin  1   2 , Elisabet Hentz  1   2 , Robin T Saggers  3   4 , Daynia E Ballot  4
Affiliations

Factors influencing survival and short-term outcomes of very low birth weight infants in a tertiary hospital in Johannesburg

Kristin Ingemyr et al. Front Pediatr. .

Abstract

Background: The neonatal mortality rate in South Africa is lower than the global average, but still approximately five times higher than some European and Scandinavian countries. Prematurity, and its complications, is the main cause (35%) of neonatal deaths.

Objective: To review the maternal, delivery period and infant characteristics in relation to mortality in very low birth weight (VLBW) infants at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).

Methods: This was a retrospective descriptive study of VLBW infants admitted to CMJAH between 1 January 2017 and 31 December 2018. All infants with a birth weight between 500 to ≤ 1,500 grams were included. The characteristics and survival of these infants were described using univariate analysis.

Results: Overall survival was 66.5%. Provision of antenatal steroids, antenatal care, Cesarean section, female sex, resuscitation at birth, and 5-min Apgar score more than five was related with better survival to discharge. Among respiratory diagnoses, 82.8% were diagnosed with RDS, 70.8% received surfactant therapy and 90.7% received non-invasive respiratory support after resuscitation. At discharge, 59.5% of the mothers were breastfeeding and 30.8% spent time in kangaroo mother care.

Conclusion: The two-thirds survival rate of VLBW infants is similar to those in other developing countries but still remains lower than developed countries. This may be improved with better antenatal care attendance, coverage of antenatal steroids, temperature control after birth, improving infection prevention and control practices, breastfeeding rates and kangaroo mother care. The survival rate was lowest amongst extremely low birth weight (ELBW) infants.

Keywords: infant; low- and lower-middle-income countries; neonatal mortality; premature neonate; prematurity; short-term outcomes; survival; very low birth weight (VLBW).

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Conflict of interest statement

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.

Figures

Figure 1
Figure 1
Survival by weight category. Survival of very low birth weight infants by birth weight category.
See this image and copyright information in PMC

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