A review of delivery room resuscitation in neonates above 1500 grams birthweight in a tertiary hospital in South Africa
Abstract
ABSTRACT
Background. There is limited information on delivery room resuscitation in sub-Saharan Africa
Objectives. To audit delivery room resuscitation and determine the survival to discharge of neonates who were resuscitated in a tertiary referral centre in South Africa
Methods. This was a retrospective, descriptive study of delivery room resuscitation in all inborn neonates >1500g admitted to the neonatal unit within 24 hours at a tertiary referral hospital in Johannesburg, South Africa between 01/01/2013 and 30/06/2016
Results. There were 32081 live births during the study period. The study sample comprised 2966 neonates. . The majority of neonates were male (n=1740/2964, 58.7%). The mean birth weight was 2645 grams (SD 805) and gestational age was 36.5 weeks (SD 3.5) .The most common mode of delivery was caesarean section (CS) (1865/2948, 63.2%). . The overall mortality rate was 4.2% (125 / 2966) with 29.6 % (37/125) of the deaths occurring in the delivery room. Only 37% of babies (1089/2966) did not require resuscitation at birth. Mortality rates were 5.1% (96/1877) for babies who received oxygen at birth. Advanced delivery room resuscitation (intubation, adrenaline and /or chest compressions) was required in 7.5% (221/2966) of babies and 29.0% (64/221) died. Multivariate logistic regression revealed that the variables most strongly associated with ADRR were birth weight (OR 0.999; 95% CI 0.990- 1.000; p=0.018), presence of HIE (OR 2.902 95% CI 1.387-6.072; p=0.005) and death (OR 4.575, 95% CI 2.2112 – 9.914, p<0.001).
Conclusion.
Mothers with high risk pregnancies must be identified and referred to adequately equipped centres for delivery.
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DOI: http://dx.doi.org/10.18103/imr.v3i2.360
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