Determinants of neonatal survival following preterm delivery at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria

• Main Authors: B Bako, A Idrisa, M A Garba, S Pius, H I Obetta
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Tropical Journal of Obstetrics and Gynaecology
• Subjects: Antenatal corticosteroids; determinants; gestational age; preterm delivery; pre-labour premature rupture of membranes; perinatal mortality
• Online Access: http://www.tjogonline.com/article.asp?issn=0189-5117;year=2017;volume=34;issue=1;spage=39;epage=44;aulast=Bako

Objective: To study the determinants of neonatal survival and outcome of preterm deliveries at the Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Materials and Methods: A retrospective case-control study of women who had preterm delivery (PTD) at the UMTH, Maiduguri from January 1, 2014 to December 31, 2015 was conducted. Information on socio-demographic characteristics, antenatal care and treatment, Apgar score, Special Care Baby Unit (SCBU) and Statistical Package for Social Sciences (SPSS) admission and perinatal mortality were collated. Statistical analysis was done with SPSS. Odd ratio was used to test for association and multiple logistic regression was computed to control for confounding variables at 95% confidence interval. Results: A total of 183 preterm births (with 195 babies) and 183 term births (with 184 babies) having complete information were analyzed. PTD occurred in 10.38% (19/183) of teenage mothers and 31.16% (68/183) of the PTD were before 32 weeks of gestation. Majority of the mothers have had at least basic education (63.69%). The mean duration of admission for the preterm babies was 1.9 + 8.4 days with neonatal survival and take home baby rate being 72.31% (141/195). Neonatal survival was independently associated with gestational age at delivery >32 weeks (OR = 12.24, CI: 5.67–34.76), antenatal dexamethasone (OR = 10.82, CI: 2.38–48.22), pre-labour premature rupture of membranes (OR = 7.68, CI: 1.83–34.64), and delivery after at least 24 hour of commencement of dexamethasone (OR = 5.66, CI: 1.23–45.23). However, maternal febrile illness (OR = 0.25, CI: 0.11–0.56) and polyhydramnious (OR = 0.29, CI: 0.16–0.55) adversely affected neonatal survival. Conclusions: The neonatal survival following PTD is high. Survival is more likely in babies born after 32 weeks, PPROM, and after antenatal dexamethasone. We recommend routine use of antenatal dexamethasone injection in women at risk of PTD and planned delivery at the tertiary centre with equipments to cater for the special needs of the preterm babies.