The burden of hyaline membrane disease, mortality and its determinant factors among preterm neonates admitted at Debre Tabor General Hospital, North Central Ethiopia: A retrospective follow up study

The Effect of Maternal Haemoglobinopathies and Iron Deficiency Anaemia on Foetal Growth Restriction: A Systematic Review and Meta-Analysis

Maternal anaemia is a significant global health issue that adversely affects both maternal and foetal outcomes, particularly, intrauterine growth restriction (IUGR). This systematic review and meta-analysis aimed to consolidate existing evidence on the impact of maternal anaemia on the risk of IUGR. We conducted a comprehensive search across PubMed, Embase, Cochrane and Web of Science until 28 February 2024. Eligible studies included observational designs that reported maternal anaemia and its association with IUGR or small for gestational age (SGA) outcomes. The pooled odds ratios (ORs) were calculated using a random-effects model and heterogeneity was assessed with the I² statistic. The R software (version 4.3) was used for statistical analyses. A total of 38 studies involving 3,871,849 anaemic and 27,978,450 non-anaemic pregnant women were included. The pooled analysis demonstrated that anaemia in pregnancy is associated with a significantly increased risk of IUGR (OR = 1.30, 95% CI: 1.05-1.62, I² = 97%). Subgroup analyses by anaemia severity showed non-significant associations for mild (OR = 0.84, 95% CI: 0.58-1.23) and moderate anaemia (OR = 0.98, 95% CI: 0.48-1.98), while severe anaemia indicated a higher, though non-significant, risk of IUGR (OR = 1.42, 95% CI: 0.69-2.93). Maternal anaemia is associated with a heightened risk of IUGR, highlighting the critical need for effective management and early intervention strategies within prenatal care settings. Future research should focus on elucidating the effects of different severities of anaemia on birth outcomes, including IUGR and long-term effects later in life.

Predictors of neonatal mortality among neonates admitted to the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital, Sidama regional state, Ethiopia

BACKGROUND

Despite promising efforts, substantial deaths occurred during the neonatal period. According to estimates from the World Health Organization (WHO), Ethiopia is among the top 10 nations with the highest number of neonatal deaths in 2020 alone. This staggering amount makes it difficult to achieve the SDG (Sustainable Development Goals) target that calls for all nations to work hard to meet a neonatal mortality rate target of ≤ 12 deaths per 1,000 live births by 2030. We evaluated neonatal mortality and it's contributing factors among newborns admitted to the Neonatal Intensive Care Unit (NICU) at Hawassa University Comprehensive Specialized Hospital (HUCSH).

METHODS

A hospital-based retrospective cross-sectional study on neonates admitted to the NICU from May 2021 to April 2022 was carried out at Hawassa University Comprehensive Specialized Hospital. From the admitted 1044 cases over the study period, 225 babies were sampled using a systematic random sampling procedure. The relationship between variables was determined using bivariate and multivariable analyses, and statistically significant relations were indicated at p-values less than 0.05.

RESULTS

The magnitude of neonatal death was 14.2% (95% CI: 0.099-0.195). The most common causes of neonatal death were prematurity 14 (43.8%), sepsis 9 (28.1%), Perinatal asphyxia 6 (18.8%), and congenital malformations 3 (9.4%). The overall neonatal mortality rate was 28 per 1000 neonate days. Neonates who had birth asphyxia were 7.28 times more probable (AOR = 7.28; 95% CI: 2.367, 9.02) to die. Newborns who encountered infection within the NICU were 8.17 times more likely (AOR = 8.17; 95% CI: 1.84, 36.23) to die.

CONCLUSION

The prevalence of newborn death is excessively high. The most common causes of mortality identified were prematurity, sepsis, perinatal asphyxia and congenital anomalies. To avert these causes, we demand that antenatal care services be implemented appropriately, delivery care quality be improved, and appropriate neonatal care and treatment be made available.

Neonatal jaundice and associated factors in public hospitals of southern Ethiopia: A multi-center cross-sectional study

Background

Neonatal jaundice is one of the most prevalent problems, affecting over a million newborns globally every year. It increases the likelihood of hospitalization, lifetime disability, and death, particularly in low and middle-income countries. Despite its impact and diverse risk factors, neonatal jaundice remains underappreciated in developing nations such as Ethiopia. As a result, this study aimed to determine the magnitude and associated factors of jaundice in newborns admitted to public hospitals in south Ethiopia.

Methods

A facility-based cross-sectional study was conducted among 417 newborns from October 1, 2020, to April 30, 2021. The data was collected using pretested interviewer-administered questionnaire and checklist. Jaundice and its severity were assessed using the physician's diagnosis and the Kramer scale. Open data kit tools and Stata version 16.0 were used for data collection and analysis, respectively. Bivariable and multivariable analyses were used to identify factors associated with neonatal jaundice. An odds ratio with a 95 % confidence interval was used to assess the direction and strength of the association.

Results

Out of the newborns, 24.46 % [95 % CI: 20.42-28.88] encountered neonatal jaundice. Being male [AOR: 1.81, 95 % CI: 1.06, 3.12], birth injuries [AOR: 3.01, 95 % CI: 1.27, 7.12], perinatal asphyxia [AOR: 2.10, 95 % CI: 1.18, 3.76], hyaline membrane disease [AOR: 2.16, 95 % CI: 1.16, 4.00], sepsis [AOR: 3.30, (95 % CI: 1.67, 6.54], the combined effect of low birth weight and prematurity [AOR: 1.88, 95 % CI: 1.06, 3.35], and maternal alcohol abuse during pregnancy [AOR: 2.46, 95 % CI: 1.02, 5.94] were significantly associated with neonatal jaundice.

Conclusion

The burden of neonatal jaundice was high in the hospitals studied. Early detection and treatment of neonatal problems, counseling pregnant women to avoid consuming any level of alcohol, strict monitoring of labor and delivery, improving antenatal care utilization, and pre-discharge universal bilirubin screening of newborns are essential to reduce the incidence and complications of jaundice. The findings of this study will be used as input to initiate interventions and conduct further studies.

Antibiotic prophylaxis in pregnant with premature rupture of ovular membranes: systematic review and meta-analysis

OBJECTIVE

To perform a systematic review and meta-analysis of randomized clinical trials that compared the use of antibiotics versus placebo in premature rupture of membranes preterm and evaluated maternal, fetal and neonatal outcomes in pregnant women with premature rupture of ovular membranes at a gestational age between 24 and 37 weeks.

METHODS

A search was conducted using keywords in PubMed, Cochrane, Biblioteca Virtual em Saúde and Biblioteca Digital de Teses e Dissertações da USP between August 2018 and December 2021. A total of 926 articles were found. Those included were randomized clinical trials that compared the use of antibiotics versus placebo in the premature rupture of preterm membranes. Articles referring to antibiotics only for streptococcus agalactiae prophylaxis were excluded. The retrieved articles were independently and blindly analyzed by two reviewers. A total of 24 manuscripts met the inclusion criteria and 21 articles were included for quantitative analysis.

RESULTS

Among the maternal outcomes analyzed, there was a prolongation of the latency period that was ≥7 days. In addition, we observed a reduction in chorioamnionitis in the group of pregnant women who used antibiotics. As for endometritis and other maternal outcomes, there was no statistically significant difference between the groups. Regarding fetal outcomes, antibiotic prophylaxis worked as a protective factor for neonatal sepsis. Necrotizing enterocolitis and respiratory distress syndrome showed no statistically significant differences.

CONCLUSION

The study showed positive results in relation to antibiotic prophylaxis to prolong the latency period, new randomized clinical trials are needed to ensure its beneficial effect.

PROSPERO DATABASE REGISTRATION

(www.crd.york.ac.uk/prospero) under number CRD42020155315.