Conclusion et recommandations :
L'incidence du très faible poids de naissance à
l'HGOPY était de 5,8% et le taux de survie global était de 26,5%.
Notons toutefois une amélioration du taux de survie atteignant 49% en
2011. Les principales causes de morbidité étaient la
prématurité, les infections néonatales et l'asphyxie
néonatale. Les facteurs qui influençaient significativement la
survie étaient un poids de naissance élevé, un âge
gestationnel avancé, un score d'Apgar supérieur à 7
à la 5ème minute, la multiparité, l'absence de
réanimation avancée à la naissance et de détresse
respiratoire.
A la lumière de nos résultats, nous recommandons
d'orienter les ressources existantes au profit des nouveau-nés de
très faible poids de naissance afin d'améliorer leur pronostic,
d'informer les femmes sur les facteurs prédisposant au très
faible poids de naissance et sur la manière d'y remédier, enfin,
nous souhaitons que les unités de néonatalogie des structures
sanitaires de notre pays soient dotées du matériel
nécessaire à une prise en charge optimale de tous les
nouveau-nés à risque.
SUMMARY
Background and Objectives
According to the World
Health Organization, 40% of deaths before the age of 5
occur in the neonatal period. Low birth weight is
the third leading cause of death in
neonates after neonatal sepsis
and prematurity. Newborns with low birth weight are 20
times more likely to die during their first month of life than
neonates born with normal weight. This risk is even higher
among infants with very low birth weight, in whom it
is usually associated with extreme immaturity. From the
2004 Demographic and Health Survey in Cameroon, 12% of Cameroonian
newborns weigh less than 2500g at birth. This
survey makes no mention of newborn infants weighing less
than 1500g. The main objective of this study was
to identify factors that influence
the outcome of newborns with very low birth
weight, and assess the epidemiological profile of these neonates
in the Yaoundé Gyneco-Obstetric and Pediatric Hospital (YGOPH).
Methodology
This was a descriptive, analytic and retrospective study,
??from the records of infants of very low birth
weight, admitted between May 2003 and December
2011, at the neonatal unit of YGOPH. We conducted
a comparison between survivors and deceased in order to
identify maternal and neonatal factors associated with the
hospital outcome of very low birth weight infants. Data
analysis was performed using the Statistical software
Package for Social Sciences(SPSS ™) version
16.0 and the significance level was set at P value
<0.05.
Results
From 1st May 2003 to 31st
December 2011, we recorded 414 cases of very low birth weight
in YGOPH, giving an incidence of 5.8%. We excluded 17
cases whose files did not have sufficient data to be exploited. Out
of the 397 very low birth weight infants included, only 105 survived,
giving an overall survival rate of 26.5%. The main causes
of morbidity were prematurity (98.9%), neonatal
sepsis (37.5%) and birth asphyxia (32%). We recorded
52% females and 48% males. About 81% of these neonates studied
weighed more than 1000g at birth and 55% of them
were aged between 28 and 32 weeks of amenorrhea. The mean
birth weight and gestational age were 1160.04g and
29.8weeks of amenorrhea respectively. Most mothers were single,
unemployed and aged between 18 and 34
years. Survival increased significantly with increase in
the parity of mothers, birth weight, gestational
age and Apgar score at the 5th minute. On the other hand,
survival was significantly reduced in those who received
advanced resuscitation at birth and those
who presented with respiratory distress.
| 
