Region-specific burden of late preterm birth during the first week of life
| dc.contributor.advisor | Smith, Johan | en_ZA |
| dc.contributor.advisor | Hassan, Haseena | en_ZA |
| dc.contributor.author | Van Niekerk, Magriet | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Department of Paediatrics and Child Health. | en_ZA |
| dc.date.accessioned | 2020-02-25T06:12:39Z | |
| dc.date.accessioned | 2020-04-28T15:11:15Z | |
| dc.date.available | 2020-02-25T06:12:39Z | |
| dc.date.available | 2020-04-28T15:11:15Z | |
| dc.date.issued | 2020-03 | |
| dc.description | Thesis (MMed)--Stellenbosch University, 2020. | en_ZA |
| dc.description.abstract | Introduction: International data indicate that the number of late-premature babies (34-36.6 weeks) are on the increase.1,2,3,4 Late preterm newborns also account for the largest subset of all preterm births (74%). With regard to South Africa, no information exists on the potential disease burden associated with a late preterm birth. Determining the disease burden related to late premature births is especially important since gestation is often inaccurate and weight criteria rather than gestation is used for discharge. Aim: The primary objective was to document morbidity and mortality within the first week of life of late premature births at a tertiary hospital in the Western Cape, South Africa. Methods: A prospective descriptive study of late-premature babies born at Tygerberg Hospital between 1 March and 31 May 2018 was performed. Babies admitted to both the neonatal and postnatal wards were included. Data was collected on day 1, 3 and 7 of life, with telephonic interview of the mother in the case of discharge. Obstetric data as well as demographic data, morbidity and mortality data was collected on the neonate. Specific interventions including need for admission, length of stay, respiratory support, surfactant administration, antibiotic prescription, poor feeding and jaundice were recorded.3 Neonatal data was stratified according to gestation 34.0-34.6 vs 35.0-36.6 weeks, as the former is routinely admitted if neonatal capacity allows. Results: 117 babies were enrolled, 63 in the 34-34.6 week group and 54 in the 35.0-36.6 weeks group. The primary obstetric reason for delivery was pre-eclampsia/eclampsia followed by spontaneous preterm labour. The median maternal age was 27.5 years in the younger gestational group and 29 years in the older group. There was a large variation in weight in both groups of babies, with the median weight in the 34-34.6 group being 1895g (Range 1428g-3695g), and in the older gestation being 2140g (Range 1030g- 5000g). A total of 98 babies required admission to the neonatal service. In the younger gestation group, 62 babies (98.4%) were admitted, while 36 (66.7%) of the 35-36.6 week group required admission to the neonatal ward. The majority of the babies in both groups had respiratory distress, requiring nasal continuous positive airway pressure (nCPAP). None of the babies required surfactant treatment or invasive ventilation. Antibiotics were initiated in 46 of the admitted babies, 29 of them continuing by day 3. Ten (10.8%) babies developed jaundice on day 1 and 11 (11.9%) had documented hypoglycaemia. By day 3, 50% of the babies were not able to satisfactorily breastfeed. On day three of life, only 5 of the 117 infants were discharged home. Fifteen of the infants were still admitted only for maternal reasons, while 96 babies still required medical attention. By day 7, 54 babies (63.2% of original cohort) were still admitted for medical care and another 8 were only in hospital due to maternal reasons. None of the babies during the study period demised, however possible late neonatal death was outside the scope of this study. Conclusion: There was a high burden of morbidity amongst the late-preterm group. In this specific group of babies, discharge policies should be reviewed. | en_ZA |
| dc.description.version | Masters | en_ZA |
| dc.embargo.terms | 2020-12 | |
| dc.format.extent | 13 pages | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/10019.1/108374 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
| dc.rights.holder | Stellenbosch University | en_ZA |
| dc.subject | Premature babies -- Mortality | en_ZA |
| dc.subject | Preterm-born children | en_ZA |
| dc.subject | Birth weight, Low | en_ZA |
| dc.subject | Premature babies -- Morbidity | en_ZA |
| dc.title | Region-specific burden of late preterm birth during the first week of life | en_ZA |
| dc.type | Thesis | en_ZA |