Pediatrics, Neonatology & Primary Care

Biography

Biography: Lamidi Isah AUDU

Abstract

Background: Although official age of fetal viability in Nigeria is 28 weeks, there are pockets of reports of survival of babies delivered at younger Gestational Age (GA) from different parts of the country. This is likely to generate important ethical and medical concerns in our approach to management of births occurring before the official GA of 28 weeks. Aim: To determine the gestational age specific neonatal mortality among preterm deliveries at the National Hospital Abuja. Methods: A retrospective review of relevant data from the National Hospital Neonatal Registry Database (REDCap) was undertaken to determine the mortality rate of preterm babies managed in NICU from January 2017 to February 2018. Disaggregated GA specific mortality rates were also computed to determine the fetal age at which extra uterine neonatal survival rate was at least 50%. GA estimation was based on mothers’ LMP in over 96% of cases. Results: Sixty two (62) of 305 preterm babies admitted died during hospitalization giving a mortality rate of 20.3%. This was significantly higher than the mortality rate among term babies (7.5%, P=0.01) hospitalized over the same period. Antenatal steroid use was low (11.2%), 188 (25.8%) received CPAP for RDS and none of the babies received surfactant. There were no survivors among babies delivered at GA of 22-25 weeks (11, 3.6%). However survival rate at 26 weeks gestation was 53.8% and this subsequently increased reaching a peak of 80% survival at 36 weeks. RDS accounted for 53.9% of all deaths. Conclusion: GA, place of delivery and birth weight were significantly associated with risk of death. It is concluded that the survival rate (53.8%) of babies at GA 26/52 despite minimal antenatal interventions and limited postnatal respiratory support was reasonably high and this could serve the basis for discussions for a downward review of age of fetal viability in Nigeria.