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Journal of Primary Health Care & General Practice

JPHCGP

Aabstract

Research Article

Predictors of Mortality in Nigerian Babies with Respiratory Distress in a Resource-Constrained Centre: Implication for Primary Health Care

Bankole Peter Kuti, Lasisi Oluwafemi Mohammed, Tolulope Ogundele, Oluwatobi Faith Folarin

Correspondence Address :

Bankole Peter Kuti
Senior Lecturer/Consultant Paediatrician Obafemi Awolowo University
Ile-Ife, Nigeria
Tel: 234 803 465 9848
Email: kutitherapy@yahoo.com

Received on: December 04, 2017, Accepted on: December 14, 2017, Published on: December 21, 2017

Citation: Bankole Peter Kuti, Lasisi Oluwafemi Mohammed, Tolulope Ogundele, Oluwatobi Faith Folarin (2017). Predictors of Mortality in Nigerian Babies with Respiratory Distress in a Resource-Constrained Centre: Implication for Primary Health Care

Copyright: 2017 Bankole Peter Kuti, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
Background: Neonatal respiratory distress is a major danger sign of ill-health in babies. Identifying and addressing mortality-associated factors in newborns with respiratory distress can improve survival. This study sets out to determine the ante-partum, sociodemographic and clinical predictors of mortality in babies admitted with respiratory distress at a referral hospital in Ilesa, south west Nigeria.
Method: Babies with respiratory distress were consecutively recruited over a 10 month period. Socio-demographic, maternal and perinatal factors as well as examinations and laboratory findings were compared between the survivors and cases of mortality. Binary logistic regression was used to determine the predictors of mortality.
Results: The median (Inter quartile range) age at presentation of the 250 recruited babies was 4.0 (1.0 - 26.0) hours, male to female ratio was 1.3:1 and 37.2% were preterm. The majorities (70.8%) of the babies were admited within 24hours of delivery and twothirds were referred from primary health facilities. Forty three (17.2%) of the babies died and mortality was significantly associated with maternal age, lack of antenatal care, mode and place of delivery, low birth weight and severity of respiratory distress. Infants of teenage mothers (OR= 6.551, 95%CI 1.666-27.121; p = 0.007); lack of antenatal care (OR = 6.018,
95%CI 1.072 - 10.858, p = 0.028); Hypoxaemia at presentation (OR= 5.400, 95%CI = 2.103 - 38.498) and respiratory distress syndrome in LBW/preterms (OR = 2.018, 95%CI = 1.015 - 6.355; p = 0.001) were independent predictors of mortality.
Conclusion: Respiratory distress significantly contributes to neonatal mortality at the referral centre. Pregnant teenagers, those with no antenatal care should be referred to deliver their babies in better equipped facilities while newborns with respiratory distress who are LBW, those with severe respiratory distress (high Downes score) and hypoxaemia should be promptly referred for adequate care and respiratory support to increase their chances of survival.
Keywords: Newborns; Mortality; Respiratory distress; Resource-poor centres

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