Morbidity and Mortality of Premature Birth at Ramadi Teaching Hospital for Maternity and Children/West of Iraq
Abstract
The consequences of prematurity is a very fundamental subject. With improvement of neonatal care facilities, it still comprises a burden on health care centers, with a lot of costs and increasing mortality. To determine the morbidity and mortality of premature birth at Ramadi teaching hospital for maternity and children. A prospective cohort study was done at Ramadi teaching hospital for maternity and children/Anbar/Iraq. Data was collected from 1st July 2022 till 1st January 2023, all live births at Ramadi Teaching Hospital during that period were included. All admitted premature newborns were followed up in neonatal care unit for variable periods depending on clinical situation and those who develop complications were recorded (Respiratory distress syndrome, Intracranial hemorrhage, asphyxia, sepsis, hypoglycemia, pneumothorax) furthermore any newborn died during hospitalization period also recruited. The total number of neonates was 204. All of them were preterm babies. About 121 (59.3%) need resuscitation while 83 (40.7%) not need resuscitation. Regarding complications respiratory distress syndrome 156(76.5%), intracranial hemorrhage 9(4.4%), asphyxia 17(8.3%), sepsis 35(17.2%), hypoglycemia 22 (10.8%), pneumothorax 31(15.2%). 148 premature babies discharged well (72.5%) while 56 premature newborns died (27.5%). Result of analysis of logistic regression to determine the relationship between different risk factors and mortality shows significant association with birth weight <1500-gram Odd’s ratio (30.041), and triplet pregnancy Odd’s ratio (3.62). Respiratory distress syndrome is the most prevalent complication of preterm babies followed by sepsis. Extremely low birth weight and triplet pregnancy have significant association with preterm mortality
1. Fathi A, Barak M, Damandan M, Amani F, Moradpour R, Khalilova I, et al. Neonatal Screening for Glucose-6-phosphate dehydrogenase Deficiency in Ardabil Province, Iran, 2018-2019. Cell Mol Biomed Rep 2021;1:1-6.
2. Koteswari P, Lakshmi PA, Yaseen M, sultana S, Tabassum A, Soumya P, et al. Preterm birth: causes and complications observed in tertiary care hospitals. Cell Mol Biomed Rep 2022;2:202-12.
3. Walani SR. Global burden of preterm birth. Int J Gynaecol Obstet 2020;150:31-3.
4. Li X, Huang S, Jiao A, Yang X, Yun J, Wang Y, et al. Association between ambient fine particulate matter and preterm birth or term low birth weight: An updated systematic review and meta-analysis. Environ Pollut 2017;227:596-605.
5. Backes CH, Rivera BK, Pavlek L, Beer LJ, Ball MK, Zettler ET, et al. Proactive neonatal treatment at 22 weeks of gestation: a systematic review and meta-analysis. Am J Obstet Gynecol 2021;224:158-74.
6. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet 2016;388:3027-35.
7. Mapp S, Gabel SG. It is easier to build strong children than to repair broken men. J Hum Rights Soc Work 2019;4:145-6.
8. Vogel JP, Chawanpaiboon S, Moller AB, Watananirun K, Bonet M, Lumbiganon P. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol 2018;52:3-12.
9. Zhu X, Lei X, Dong W. Change to Hearing Loss–Related Risks and Screening in Preterm Infants. Am J Perinatol 2022;39:501-12.
10. Zainal H, Dahlui M, Soelar SA, Su TT. Cost of preterm birth during initial hospitalization: a care provider’s perspective. PLoS One 2019;14:e0211997.
11. de Gamarra-Oca LF, Ojeda N, Gomez-Gastiasoro A, Pena J, Ibarretxe-Bilbao N, García-Guerrero MA, et al. Long-term neurodevelopmental outcomes after moderate and late preterm birth: a systematic review. J Pediatr 2021;237:168-76. e11.
12. Amjadi N, Talayeh M, Momeni M, Mansouri N. The comparison of umbilical cord artery pH in newborns with and without thick meconium stained amniotic fluid. Cell Mol Biomed Rep 2023;3:222-6.
13. Çelik E, Öztürk A. Evaluation of the mortality and morbidity of premature infants during a five-year period in the neonatal intensive care unit. Cureus 2021;13:e17790.
14. Andegiorgish AK, Andemariam M, Temesghen S, Ogbai L, Ogbe Z, Zeng L. Neonatal mortality and associated factors in the specialized neonatal care unit Asmara, Eritrea. BMC Public Health 2020;20:1-9.
15. Hadgu FB, Gebretsadik LG, Mihretu HG, Berhe AH. Prevalence and factors associated with neonatal mortality at Ayder Comprehensive Specialized Hospital, Northern Ethiopia. A cross-sectional study. Pediatric Health Med Ther 2020;11:29-37.
16. Bell EF, Hintz SR, Hansen NI, Bann CM, Wyckoff MH, DeMauro SB, et al. Mortality, in-hospital morbidity, care practices, and 2-year outcomes for extremely preterm infants in the US, 2013-2018. JAMA 2022;327:248-63.
17. Ahmed MAA, Mahgoub HM, Al-Nafeesah A, Al-Wutayd O, Adam I. Neonatal mortality and associated factors in the neonatal intensive care unit of Gadarif Hospital, Eastern Sudan. Children (Basel) 2022;9:1725.
18. Jiang S, Yan W, Li S, Zhang L, Zhang Y, Shah PS, et al. Mortality and morbidity in infants< 34 weeks' gestation in 25 NICUs in China: a prospective cohort study. Front Pediatr 2020;8:33.
19. Xu Y, Zhu X, Wang H, Pan Z, Li X, Guo X, et al. Prevalence of major morbidities and outcome of all hospitalized neonates. A retrospective cohort study of Huai’an neonatal survivals. J Matern Fetal Neonatal Med 2022;35:9800-10.
20. Mwangi A, Okube OT, Kamau J. Maternal and Neonatal Factors Associated with Mortality of Preterm Babies Admitted in Newborn Unit of Kenyatta National Hospital, Kenya. Open J Obstet Gynecol 2022;12:1219-36.
21. Carriere D, Kantor E, Torchin H, Le Ray C, Jarreau PH, Zana-Taieb E. Mortality and morbidity of preterm neonates weighing less than 750 g: A 2-year retrospective cohort study. Arch Pediatr 2020;27:227-32.
22. Egesa WI, Odong RJ, Kalubi P, Ortiz Yamile EA, Atwine D, Turyasiima M, et al. Preterm neonatal mortality and its determinants at a tertiary hospital in Western Uganda: a prospective cohort study. Pediatric Health Med Ther 2020;11:409-20.
23. Al-Assadi AF, Al-Haroon DS, Al-Rubaye A, Abdul-Rahman BA. Risk Factors and neonatal outcome among preterm birth at Basrah central hospitals. Med J Basrah Univ 2018;36:87-96.
24. Genie YD, Kebede BF, Zerihun MS, Beyene DT. Morbidity and mortality patterns of preterm low birthweight neonates admitted to referral hospitals in the Amhara region of Ethiopia: retrospective follow-up study. BMJ Open 2022;12:e054574.
25. Mohamed Rasheed ZB, Hong J, Yaacob H, Omar SZ. Prevalence of Preterm Birth and Perinatal Outcomes in a Tertiary Hospital in Malaysia. Cureus 2024;16:e55284.
26. Olack B, Santos N, Inziani M, Moshi V, Oyoo P, Nalwa G, et al. Causes of preterm and low birth weight neonatal mortality in a rural community in Kenya: evidence from verbal and social autopsy. BMC Pregnancy Childbirth 2021;21:536.
27. Kondowe FJM, Clayton P, Gittins M, D'Souza SW, Brison DR, Roberts SA. Growth of twins conceived using assisted reproductive treatments up to 5 years old: a national growth cohort. Hum Reprod 2023;38:751-61.
28. Lin J, Zhu Y, Wang B, Du T, Zhang K, Zhu Q, et al. Relationships between birth weight discordance and maternal and perinatal risks among twin pregnancies conceived following frozen embryo transfer. Hum Reprod 2023;38:2011-9.
29. Meng X, Huang J, Yuan P, Wang X, Shi X, Zhao Y, et al. Outcomes of fetal reduction versus expectant management in dichorionic triamniotic triplets. Prenat Diagn 2023;43:1442-9.
30. Kahraman FU, Ovalı HF, Say ZA. Clinical Features of Late-preterm vs. Term Newborns: A Case-control Study. Kafkas J Med Sci 2020;10:8-14.
31. Celik FC. Morbidity and Mortality in Late Preterm Newborns Followed in a Neonatal Intensive Care Unit. Iran J Neonatol 2022;13:40-5.
32. Wondie WT, Zeleke KA, Wubneh CA. Incidence and predictors of mortality among low birth weight neonates in the first week of life admitted to the neonatal intensive care unit in Northwestern Ethiopia comprehensive specialized hospitals, 2022. Multi-center institution-based retrospective follow-up study. BMC Pediatr 2023;23:489.
33. Pabbati J, Subramanian P, Renikuntla M. Morbidity and mortality of low birth weight babies in early neonatal period in a rural area teaching hospital, Telangana, India. Int J Contemp Pediatr 2019;6:1582.
34. Woelile TA, Kibret GT, Workie HM, Amare AT, Tigabu A, Aynalem YA, et al. Survival status and predictors of mortality among low-birth-weight neonates admitted to the Neonatal Intensive Care Unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia, 2020. Pediatric Health Med Ther 2021;12:451-66.
35. Eshete A, Alemu A, Zerfu TA. Magnitude and risk of dying among low birth weight neonates in Rural Ethiopia: a community-based cross-sectional study. Int J Pediatr 2019;2019:9034952.
36. Kalikkot Thekkeveedu R, Dankhara N, Desai J, Klar AL, Patel J. Outcomes of multiple gestation births compared to singleton: analysis of multicenter KID database. Matern Health Neonatol Perinatol 2021;7:15.
37. Shah PS, Kusuda S, Håkansson S, Reichman B, Lui K, Lehtonen L, et al. Neonatal outcomes of very preterm or very low birth weight triplets. Pediatrics 2018;142;e20181938.
2. Koteswari P, Lakshmi PA, Yaseen M, sultana S, Tabassum A, Soumya P, et al. Preterm birth: causes and complications observed in tertiary care hospitals. Cell Mol Biomed Rep 2022;2:202-12.
3. Walani SR. Global burden of preterm birth. Int J Gynaecol Obstet 2020;150:31-3.
4. Li X, Huang S, Jiao A, Yang X, Yun J, Wang Y, et al. Association between ambient fine particulate matter and preterm birth or term low birth weight: An updated systematic review and meta-analysis. Environ Pollut 2017;227:596-605.
5. Backes CH, Rivera BK, Pavlek L, Beer LJ, Ball MK, Zettler ET, et al. Proactive neonatal treatment at 22 weeks of gestation: a systematic review and meta-analysis. Am J Obstet Gynecol 2021;224:158-74.
6. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet 2016;388:3027-35.
7. Mapp S, Gabel SG. It is easier to build strong children than to repair broken men. J Hum Rights Soc Work 2019;4:145-6.
8. Vogel JP, Chawanpaiboon S, Moller AB, Watananirun K, Bonet M, Lumbiganon P. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol 2018;52:3-12.
9. Zhu X, Lei X, Dong W. Change to Hearing Loss–Related Risks and Screening in Preterm Infants. Am J Perinatol 2022;39:501-12.
10. Zainal H, Dahlui M, Soelar SA, Su TT. Cost of preterm birth during initial hospitalization: a care provider’s perspective. PLoS One 2019;14:e0211997.
11. de Gamarra-Oca LF, Ojeda N, Gomez-Gastiasoro A, Pena J, Ibarretxe-Bilbao N, García-Guerrero MA, et al. Long-term neurodevelopmental outcomes after moderate and late preterm birth: a systematic review. J Pediatr 2021;237:168-76. e11.
12. Amjadi N, Talayeh M, Momeni M, Mansouri N. The comparison of umbilical cord artery pH in newborns with and without thick meconium stained amniotic fluid. Cell Mol Biomed Rep 2023;3:222-6.
13. Çelik E, Öztürk A. Evaluation of the mortality and morbidity of premature infants during a five-year period in the neonatal intensive care unit. Cureus 2021;13:e17790.
14. Andegiorgish AK, Andemariam M, Temesghen S, Ogbai L, Ogbe Z, Zeng L. Neonatal mortality and associated factors in the specialized neonatal care unit Asmara, Eritrea. BMC Public Health 2020;20:1-9.
15. Hadgu FB, Gebretsadik LG, Mihretu HG, Berhe AH. Prevalence and factors associated with neonatal mortality at Ayder Comprehensive Specialized Hospital, Northern Ethiopia. A cross-sectional study. Pediatric Health Med Ther 2020;11:29-37.
16. Bell EF, Hintz SR, Hansen NI, Bann CM, Wyckoff MH, DeMauro SB, et al. Mortality, in-hospital morbidity, care practices, and 2-year outcomes for extremely preterm infants in the US, 2013-2018. JAMA 2022;327:248-63.
17. Ahmed MAA, Mahgoub HM, Al-Nafeesah A, Al-Wutayd O, Adam I. Neonatal mortality and associated factors in the neonatal intensive care unit of Gadarif Hospital, Eastern Sudan. Children (Basel) 2022;9:1725.
18. Jiang S, Yan W, Li S, Zhang L, Zhang Y, Shah PS, et al. Mortality and morbidity in infants< 34 weeks' gestation in 25 NICUs in China: a prospective cohort study. Front Pediatr 2020;8:33.
19. Xu Y, Zhu X, Wang H, Pan Z, Li X, Guo X, et al. Prevalence of major morbidities and outcome of all hospitalized neonates. A retrospective cohort study of Huai’an neonatal survivals. J Matern Fetal Neonatal Med 2022;35:9800-10.
20. Mwangi A, Okube OT, Kamau J. Maternal and Neonatal Factors Associated with Mortality of Preterm Babies Admitted in Newborn Unit of Kenyatta National Hospital, Kenya. Open J Obstet Gynecol 2022;12:1219-36.
21. Carriere D, Kantor E, Torchin H, Le Ray C, Jarreau PH, Zana-Taieb E. Mortality and morbidity of preterm neonates weighing less than 750 g: A 2-year retrospective cohort study. Arch Pediatr 2020;27:227-32.
22. Egesa WI, Odong RJ, Kalubi P, Ortiz Yamile EA, Atwine D, Turyasiima M, et al. Preterm neonatal mortality and its determinants at a tertiary hospital in Western Uganda: a prospective cohort study. Pediatric Health Med Ther 2020;11:409-20.
23. Al-Assadi AF, Al-Haroon DS, Al-Rubaye A, Abdul-Rahman BA. Risk Factors and neonatal outcome among preterm birth at Basrah central hospitals. Med J Basrah Univ 2018;36:87-96.
24. Genie YD, Kebede BF, Zerihun MS, Beyene DT. Morbidity and mortality patterns of preterm low birthweight neonates admitted to referral hospitals in the Amhara region of Ethiopia: retrospective follow-up study. BMJ Open 2022;12:e054574.
25. Mohamed Rasheed ZB, Hong J, Yaacob H, Omar SZ. Prevalence of Preterm Birth and Perinatal Outcomes in a Tertiary Hospital in Malaysia. Cureus 2024;16:e55284.
26. Olack B, Santos N, Inziani M, Moshi V, Oyoo P, Nalwa G, et al. Causes of preterm and low birth weight neonatal mortality in a rural community in Kenya: evidence from verbal and social autopsy. BMC Pregnancy Childbirth 2021;21:536.
27. Kondowe FJM, Clayton P, Gittins M, D'Souza SW, Brison DR, Roberts SA. Growth of twins conceived using assisted reproductive treatments up to 5 years old: a national growth cohort. Hum Reprod 2023;38:751-61.
28. Lin J, Zhu Y, Wang B, Du T, Zhang K, Zhu Q, et al. Relationships between birth weight discordance and maternal and perinatal risks among twin pregnancies conceived following frozen embryo transfer. Hum Reprod 2023;38:2011-9.
29. Meng X, Huang J, Yuan P, Wang X, Shi X, Zhao Y, et al. Outcomes of fetal reduction versus expectant management in dichorionic triamniotic triplets. Prenat Diagn 2023;43:1442-9.
30. Kahraman FU, Ovalı HF, Say ZA. Clinical Features of Late-preterm vs. Term Newborns: A Case-control Study. Kafkas J Med Sci 2020;10:8-14.
31. Celik FC. Morbidity and Mortality in Late Preterm Newborns Followed in a Neonatal Intensive Care Unit. Iran J Neonatol 2022;13:40-5.
32. Wondie WT, Zeleke KA, Wubneh CA. Incidence and predictors of mortality among low birth weight neonates in the first week of life admitted to the neonatal intensive care unit in Northwestern Ethiopia comprehensive specialized hospitals, 2022. Multi-center institution-based retrospective follow-up study. BMC Pediatr 2023;23:489.
33. Pabbati J, Subramanian P, Renikuntla M. Morbidity and mortality of low birth weight babies in early neonatal period in a rural area teaching hospital, Telangana, India. Int J Contemp Pediatr 2019;6:1582.
34. Woelile TA, Kibret GT, Workie HM, Amare AT, Tigabu A, Aynalem YA, et al. Survival status and predictors of mortality among low-birth-weight neonates admitted to the Neonatal Intensive Care Unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia, 2020. Pediatric Health Med Ther 2021;12:451-66.
35. Eshete A, Alemu A, Zerfu TA. Magnitude and risk of dying among low birth weight neonates in Rural Ethiopia: a community-based cross-sectional study. Int J Pediatr 2019;2019:9034952.
36. Kalikkot Thekkeveedu R, Dankhara N, Desai J, Klar AL, Patel J. Outcomes of multiple gestation births compared to singleton: analysis of multicenter KID database. Matern Health Neonatol Perinatol 2021;7:15.
37. Shah PS, Kusuda S, Håkansson S, Reichman B, Lui K, Lehtonen L, et al. Neonatal outcomes of very preterm or very low birth weight triplets. Pediatrics 2018;142;e20181938.
| Files | ||
| Issue | Vol 62 No 3 (2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/acta.v62i3.17115 | |
| Keywords | ||
| Neonate Prematurity Morbidity Mortality Ramadi city | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Ali S, Shitran R. Morbidity and Mortality of Premature Birth at Ramadi Teaching Hospital for Maternity and Children/West of Iraq. Acta Med Iran. 2024;62(3):136-143.
