Outcomes of periviable neonates admitted to a resource-restricted hospital, Cape Town, South Africa.
Date
2021-04
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
ENGLISH ABSTRACT: Background: Periviability, defined as a gestational age of 20 0/7 to 25 6/7 weeks, is considered the limit of foetal maturity in developed countries, where a reasonable chance of survival exists. The outcome of these neonates in Sub-Saharan Africa is poorly described. Objectives: The study aimed to describe the mortality and morbidities of periviable neonates admitted to a resource-restricted hospital in South Africa. Methods: This was a retrospective, descriptive study performed at Tygerberg Hospital, Cape Town, South Africa, between January 2017 and December 2018. All periviable neonates, defined as a gestational age ≤27 weeks and/or birth weight of ≤750g, born at, or admitted to, Tygerberg Hospital within 24 hours of age, were included. Results: The study population consisted of 186 periviable neonates: 157 (84.4%) of the neonates were ≤27 weeks, 101 (54.3%) were ≤750g and 72 (38.7%) were ≤27 weeks and ≤750g at birth. Sixteen percent of periviable neonates had a birthweight <3rd centile i.e., severe intrauterine growth restriction (IUGR). Neonatal morbidities varied with gestational age. Overall survival rate was 51.1%, with survival increasing with increasing gestational age. Morbidities per gestational age and birth weight category are described. Most periviable neonates received comfort care or specific supportive care only, congruent with the provincial periviability guidelines. Conclusion: This is the first study to describe survival and morbidities of neonates delivered at the periviable limit of gestational age, defined as a gestational age ≤27 weeks and/or birth weight of ≤750g, in a resource-restricted hospital in South Africa. Despite restricted resources and limited care, nearly 50% of periviable neonates survived.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MMed)--Stellenbosch University, 2021
Keywords
Gestational age -- South Africa, Newborn infants -- Mortality -- South Africa, Newborn morbidity -- South Africa, Neonatology -- South Africa, UCTD