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NEONATAL SURVIVAL OF INFANTS LESS THAN 2000 GRAMS BORN AT KENYATTA NATIONAL HOSPITAL
Abstract
Background: Survival of patients is regularly used as a measure of the level and appropriateness
of medical care provided by institutions. Newborn services have been evaluated in this
manner since the 1960s. Though Kenyatta National Hospital has provided neonatal services
for over 25 years, no survival data for the low birth weight infants has been published since
1978.
Objective: To determine the birthweight specific neonatal survival of infants born weighing
less than 2000 grams at Kenyatta National Hospital.
Design: A cross sectional survey.
Setting: Newborn Unit, Kenyatta National Hospital, Nairobi.
Main outcome measures: The proportion of infants surviving the first 28 days of life grouped
in the following birthweight categories; below 1000 grams (extremely low birthweight), 1000
- 1499 grams (very low birthweight) and 1500 - 1999 grams (low birthweight).
Results: The overall neonatal survival of 163 infants born below 2000 grams was 62.6%. None
of the 23 infants born less than 1000 grams survived the neonatal period. Bigger infants fared
much better with 68% (n=73) of the 1000 - 1499 and 78% (n=67) of the 1500-1999 gram groups
surviving. Survival based on gestational age was also determined. Sixty nine per cent of infants
born between 32 and 35 weeks survived while only 27% and 9% of the 28 - 31 weeks and those
less than 28 weeks survived respectively. When the patients were analysed for age at death, it
was found that over 28% of the deaths occurred within the first day and by the seventh day,
more than 70% had died. Less than 30% of the deaths occurred after the first week. The
commonest clinical syndromes seen were infection (41%) and respiratory distress (43%).
Conclusion: Neonatal survival rates of low birthweight infants are still much lower than
those observed in developed countries as far back as the early 1970’s. The big proportion of
deaths occurring during the first week, and in particular the first day, is due to lack of
neonatal intensive care facilities and inadequate obstetric services.
of medical care provided by institutions. Newborn services have been evaluated in this
manner since the 1960s. Though Kenyatta National Hospital has provided neonatal services
for over 25 years, no survival data for the low birth weight infants has been published since
1978.
Objective: To determine the birthweight specific neonatal survival of infants born weighing
less than 2000 grams at Kenyatta National Hospital.
Design: A cross sectional survey.
Setting: Newborn Unit, Kenyatta National Hospital, Nairobi.
Main outcome measures: The proportion of infants surviving the first 28 days of life grouped
in the following birthweight categories; below 1000 grams (extremely low birthweight), 1000
- 1499 grams (very low birthweight) and 1500 - 1999 grams (low birthweight).
Results: The overall neonatal survival of 163 infants born below 2000 grams was 62.6%. None
of the 23 infants born less than 1000 grams survived the neonatal period. Bigger infants fared
much better with 68% (n=73) of the 1000 - 1499 and 78% (n=67) of the 1500-1999 gram groups
surviving. Survival based on gestational age was also determined. Sixty nine per cent of infants
born between 32 and 35 weeks survived while only 27% and 9% of the 28 - 31 weeks and those
less than 28 weeks survived respectively. When the patients were analysed for age at death, it
was found that over 28% of the deaths occurred within the first day and by the seventh day,
more than 70% had died. Less than 30% of the deaths occurred after the first week. The
commonest clinical syndromes seen were infection (41%) and respiratory distress (43%).
Conclusion: Neonatal survival rates of low birthweight infants are still much lower than
those observed in developed countries as far back as the early 1970’s. The big proportion of
deaths occurring during the first week, and in particular the first day, is due to lack of
neonatal intensive care facilities and inadequate obstetric services.
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