Summary
Background and Objectives
According to the World Health Organisation (WHO), 20
million children are born each year with birth weights less than 2,500 grams,
constituting 17 and 7% of all births in developing and developed countries
respectively. From the 2004 Demographic Health Survey in Cameroon, the rate of
low birth weight babies stands at 12%. Low birth weight (LBW) is thus a major
public health problem in Cameroon.
The aim of this study was to identify risk factors of low birth
weights and assess the outcome of these neonates in the neonatology unit of the
Yaounde Gynaeco Obstetric and Paediatric Hospital.
Methodology
It was a case-control, descriptive, analytic and
retrospective study from May 2003 to December 2008. The admission and discharge
registers and files of all neonates admitted in the neonatology unit of this
hospital were used. For all the neonates included in the study, the following
parameters were noted: age on admission, weight, sex, gestational age, birth
history, outcome, length of hospital stay, time and cause of eventual deaths,
and the socio-demographic and obstetrical profile of the mothers. The data was
analyzed with the SPSS version 10.1 software. Statistical significance was
noted for a probability value of < 0.05, and correlation assessed by the
Spearman's rank correlation coefficient R.
Results
Out of 4712 patients admitted in the
neonatology unit from 2003 to 2008, 980 had low birth weights, giving a
prevalence of 20.79%. This prevalence varied from year to year. Following a
peak of 37.45% in 2004, it declined to a nadir of 13.13% in 2008. The
proportion of hypotrophic premature babies was significantly higher than that
of hypotrophic full terms (85.6% versus 14.4%) (P<0.001). Females
outnumbered males with 51.4% and 48.6% of the cases respectively, but the
difference was not statistically significant (P=0.892). Age of the mother less
than 20 years, low educational level, primiparity, prenatal visits less than 4,
multiple pregnancies, and maternal disorders as malaria, urogenital infections
and hypertension constituted the main determinants.
Hospital mortality was high with 369 deaths (37.7%) of which
293 (79.04%), occurred during the early neonatal period. Extremely low birth
weight, grand prematurity, low Apgar scores, referrals, births in lower level
health facilities and multiple births were identified as high risk factors for
mortality.
Neonatal infections, birth asphyxia, prematurity and
congenital malformations were the main causes of death. Hospital stay was
longer for low birth weight neonates, 9.35 against 4.21 days for normal birth
weight babies.
Conclusions and Recommendations
This study indicates that the prevalence of low birth
weight neonates in the Yaounde Gynaeco-Obstetric and Pediatric Hospital which
stood at 20,79% is high as compared to the 12% from the 2004 Demographic
Health Survey in Cameroon and the 10% minimal target rate fixed by the WHO.
Mortality was high with a rate of 37.7%. Young age,
primiparity, poor follow- up of pregnancy and maternal infections during
pregnancy were the main determinants of LBWs.
We thus recommend that information and education of young
girls at childbearing age be pursued, and that adequate follow-up of pregnancy
and better management of LBW neonates are all necessary prerequisites to avert
this situation.
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